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Fujii H, Hara Y, Obase Y, Haranaga S, Takahashi H, Shinkai M, Terada J, Ikari J, Katsura H, Yamamoto K, Suzuki T, Tagaya E, Mukae H, Kaneko T. Nationwide survey in Japan of the causative diseases of bloody sputum and hemoptysis in departments of respiratory medicine at university hospitals and core hospitals. Respir Investig 2024; 62:395-401. [PMID: 38484503 DOI: 10.1016/j.resinv.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/10/2024] [Accepted: 02/11/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND The Guidelines for the Management of Cough and Sputum (2019) of the Japanese Respiratory Society (JRS) were the first internationally published guidelines for the management of sputum. However, the data used to determine the causative diseases of bloody sputum and hemoptysis in these guidelines were not obtained in Japan. METHODS A retrospective analysis was performed using the clinical information of patients with bloody sputum or hemoptysis who visited the department of respiratory medicine at a university or core hospital in Japan. RESULTS Included in the study were 556 patients (median age, 73 years; age range, 21-98 years; 302 males (54.3%)). The main causative diseases were bronchiectasis (102 patients (18.3%)), lung cancer (97 patients (17.4%)), and non-tuberculous mycobacterial disease (89 patients (16%)). Sex and age differences were observed in the frequency of causative diseases of bloody sputum and hemoptysis. The most common cause was lung cancer in males (26%), bronchiectasis in females (29%), lung cancer in patients aged <65 years (19%), and bronchiectasis in those aged >65 years (20%). CONCLUSIONS The present study is the first to investigate the causative diseases of bloody sputum and hemoptysis using data obtained in Japan. When investigating the causative diseases of bloody sputum and hemoptysis, it is important to take the sex and age of the patients into account.
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Affiliation(s)
- Hiroaki Fujii
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Yu Hara
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan.
| | - Yasushi Obase
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki-city, Nagasaki 852-8501, Japan
| | - Shusaku Haranaga
- Division of Infectious, Respiratory, and Digestive Medicine, First Department of Internal Medicine, University of the Ryukyus Graduate School of Medicine, 207 Uehara, Nishihara, Nakagami-gun, Okinawa 903-0215, Japan; Comprehensive Health Professions Education Center, University Hospital, University of the Ryukyus, 207 Uehara, Nishihara, Nakagami-gun, Okinawa 903-0215, Japan
| | - Hidenori Takahashi
- Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22 Higashioi, Shinagawa-ku, Tokyo 140-8522, Japan
| | - Masaharu Shinkai
- Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22 Higashioi, Shinagawa-ku, Tokyo 140-8522, Japan
| | - Jiro Terada
- Department of Respiratory Medicine, Japanese Red Cross Narita Hospital, 90-1, Iida-cho, Narita-shi, Chiba 286-8523, Japan; Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan
| | - Jun Ikari
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan
| | - Hideki Katsura
- Department of Respiratory Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjyuku-ku, Tokyo 162-8666, Japan
| | - Kazuko Yamamoto
- Division of Infectious, Respiratory, and Digestive Medicine, First Department of Internal Medicine, University of the Ryukyus Graduate School of Medicine, 207 Uehara, Nishihara, Nakagami-gun, Okinawa 903-0215, Japan
| | - Takuji Suzuki
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan
| | - Etsuko Tagaya
- Department of Respiratory Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjyuku-ku, Tokyo 162-8666, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki-city, Nagasaki 852-8501, Japan
| | - Takeshi Kaneko
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
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Ashizawa H, Takazono T, Kawashiri SY, Nakada N, Ito Y, Ashizawa N, Hirayama T, Yoshida M, Takeda K, Iwanaga N, Takemoto S, Ide S, Mihara T, Tomari S, Sakamoto N, Obase Y, Izumikawa K, Yanagihara K, Kawakami A, Mukae H. Risk factor of non-tuberculous Mycobacterium infection in patients with rheumatoid arthritis and other autoimmune diseases receiving biologic agents: A multicenter retrospective study. Respir Investig 2024; 62:322-327. [PMID: 38401245 DOI: 10.1016/j.resinv.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/26/2024] [Accepted: 02/11/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Evidence regarding the association of the usage of biologic agents (Etanercept, Tocilizumab, adalimumab and so on), such as anti-tumor necrosis factor α, with the incidence and risk factors of non-tuberculous Mycobacteria (NTM) infection is limited. Therefore, this study aimed to investigate the incidence and risk factors of NTM and their associations with biologic agents' usage, and also investigated the potential of Mycobacterium avium complex (MAC) antibodies as a predictor of NTM infection development. METHODS This retrospective study included 672 patients with autoimmune diseases from four hospitals in Nagasaki, Japan, from January 1, 2011, to June 30, 2019, who fulfilled the inclusion criteria. RESULTS Of the 672 patients, 9 (1.3%) developed complicated NTM infection, including two with disseminated infection, after the introduction of biologic agents. Of the nine patients, two died due to NTM infection but none tested positive for MAC antibodies prior to initiation of biologic agents. The mortality rate was higher in patients complicated with NTM than without NTM (22.2% vs 2.6%, P = 0.024). The corticosteroids dosage at the time of initiating the biologic agents was significantly higher in the NTM group than in the non-NTM group (median, 17 mg vs 3 mg, P = 0.0038). CONCLUSION In the patients undergoing therapy with biologic agents, although NTM complication was rare, it could be fatal. In particular, for patients on a relatively high dose corticosteroids, careful observation is essential for identifying NTM complication, even if the MAC antibody test is negative.
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Affiliation(s)
- Hiroki Ashizawa
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | - Shin-Ya Kawashiri
- Department of Immunology and Rheumatology, Nagasaki University Hospital, Nagasaki, Japan
| | - Nana Nakada
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Yuya Ito
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Nobuyuki Ashizawa
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Infection Control and Education Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Tatsuro Hirayama
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Pharmacotherapeutics, Nagasaki University Hospital, Nagasaki, Japan
| | - Masataka Yoshida
- Department of Respiratory Medicine, Sasebo City General Hospital, Sasebo City, Nagasaki, Japan
| | - Kazuaki Takeda
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Naoki Iwanaga
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Shinnosuke Takemoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Shotaro Ide
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Infectious Disease Experts Training Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Tomo Mihara
- Department of Respiratory Medicine, Isahaya General Hospital, Isahaya City, Nagasaki, Japan
| | - Shinya Tomari
- Department of Respiratory Medicine, Isahaya General Hospital, Isahaya City, Nagasaki, Japan
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Yasushi Obase
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Koichi Izumikawa
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Department of Infection Control and Education Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Nagasaki University Hospital, Nagasaki, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
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3
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Kamata H, Takamatsu K, Fukunaga K, Chubachi S, Nakagawara K, Namkoong H, Terai H, Tanaka K, Sato S, Hagiwara E, Takei R, Kondoh Y, Takazono T, Hashimoto M, Tasaka S, Ohrui T, Tanino Y, Mineshita M, Komase Y, Miyazaki K, Nishikawa M, Ando A, Kita H, Ichihara E, Ohshimo S, Murata Y, Ishida M, Kobayashi S, Uchida T, Tateno H, Ikari J, Terashima T, Kozu Y, Tateishi T, Shinkai M, Sagara H, To Y, Ito Y, Yamamoto M, Yamamoto Y, Kita T, Ito Y, Tomii K, Fujita Y, Funaki Y, Yatera K, Yamasue M, Komiya K, Kozawa S, Manabe H, Hozumi H, Horiguchi T, Kitajima T, Nakano Y, Nagaoka T, Hojo M, Ebihara A, Kobayashi M, Takayama K, Jinta T, Sawai T, Fukuda Y, Kaneko T, Chin K, Ogura T, Mukae H, Ishii M, Yokoyama A. Pulmonary function and chest CT abnormalities 3 months after discharge from COVID-19, 2020-2021: A nation-wide multicenter prospective cohort study from the Japanese respiratory society. Respir Investig 2024; 62:572-579. [PMID: 38669898 DOI: 10.1016/j.resinv.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 02/07/2024] [Accepted: 02/17/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND No comprehensive analysis of the pulmonary sequelae of coronavirus disease 2019 (COVID-19) in Japan based on respiratory function tests and chest computed tomography (CT) has been reported. We evaluated post-COVID-19 conditions, especially focusing on pulmonary sequelae assessed by pulmonary function tests and chest CT. METHODS For this prospective cohort study, we enrolled 1069 patients who presented pneumonia at the time of admission in 55 hospitals from February 2020 to September 2021. Disease severity was classified as moderateⅠ, moderate II, and severe, defined primarily according to the degree of respiratory failure. The data on post-COVID-19 conditions over 12 months, pulmonary function, and chest CT findings at 3 months were evaluated in this study. Additionally, the impact of COVID-19 severity on pulmonary sequelae, such as impaired diffusion capacity, restrictive pattern, and CT abnormalities, was also evaluated. RESULTS The most frequently reported post-COVID-19 conditions at 3 months after COVID-19 were muscle weakness, dyspnea, and fatigue (48.4%, 29.0%, and 24.7%, respectively). The frequency of symptoms gradually decreased over subsequent months. In pulmonary function tests at 3 months, the incidence of impaired diffusion capacity and restrictive pattern increased depending on disease severity. There also were differences in the presence of chest CT abnormalities at the 3 months, which was markedly correlated with the severity. CONCLUSION We reported a comprehensive analysis of post-COVID-19 condition, pulmonary function, and chest CT abnormalities in Japanese patients with COVID-19. The findings of this study will serve as valuable reference data for future post-COVID-19 condition research in Japan.
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Affiliation(s)
- Hirofumi Kamata
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazufumi Takamatsu
- Department of Respiratory Medicine and Allergology, Kochi Medical School, Kochi University, Oko-cho, Kohasu, Nankoku, Kochi, 783-8505, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Shotaro Chubachi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kensuke Nakagawara
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Ho Namkoong
- Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hideki Terai
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Katsushi Tanaka
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Susumu Sato
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoinkawaharacho, Sakyo-ku, 606-8507, Japan
| | - Eri Hagiwara
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Kanazawa-ku, Yokohama, Kanagawa, 236-0051, Japan
| | - Reoto Takei
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, 160 Nishioiwakecho, Seto, Aichi, 489-8642, Japan
| | - Yasuhiro Kondoh
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, 160 Nishioiwakecho, Seto, Aichi, 489-8642, Japan
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Midori Hashimoto
- Department of Respiratory Medicine, NTT-East Corporation Sapporo Medical Center, South 1, West 15, Chuo-ku, Sapporo, 060-0061, Japan
| | - Sadatomo Tasaka
- Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, 5 Zaifucho, Hirosaki, Aomori, 036-8562, Japan
| | - Takashi Ohrui
- Division of Respiratory Medicine, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8512, Japan
| | - Yoshinori Tanino
- Department of Pulmonary Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Masamichi Mineshita
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Yuko Komase
- Department of Respiratory Internal Medicine, St. Marianna University School of Medicine, Yokohama Seibu Hospital, 1197-1 Yasashicho, Asahi-ku, Yokohama, Kanagawa, 241-0811, Japan
| | - Kazuhito Miyazaki
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishimachi, Kanagawa-ku, Yokohama, Kanagawa, 221-0855, Japan
| | - Masanori Nishikawa
- Department of Respiratory Medicine, Fujisawa City Hospital, 2-6-1 Fujisawa, Kanagawa, 251-8550, Japan
| | - Akira Ando
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Hideo Kita
- Department of Respiratory Medicine, Takatsuki Red Cross Hospital, 1-1-1 Abuno, Takatsuki, Osaka, 569-1045, Japan
| | - Eiki Ichihara
- Center for Clinical Oncology, Okayama University Hospital, 2-5-1 Shikatacho, Kita-ku, Okayama, 700-8558, Japan
| | - Shinichiro Ohshimo
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-0037, Japan
| | - Yoriyuki Murata
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Masayuki Ishida
- Department of Respiratory Medicine, Chikamori Hospital, 1-1-6 Okawasuji, Kochi, 780-8522, Japan
| | - Seiichi Kobayashi
- Department of Respiratory Medicine, Japanese Red Cross Ishinomaki Hospital, 71 Nishimichishita, Hebita, Ishinomaki, Miyagi, 986-8522, Japan
| | - Takahiro Uchida
- Department of Respiratory Medicine, Saitama Medical University Hospital, 38 Morohongo, Irumagun Moroyamamachi, Saitama, 350-0495, Japan
| | - Hiroki Tateno
- Department of Pulmonary Medicine, Saitama City Hospital, 2460, Oazamimuro, Midori-ku, Saitama, 336-8522, Japan
| | - Jun Ikari
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan
| | - Takeshi Terashima
- Department of Respiratory Medicine, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa, Chiba, 272-0824, Japan
| | - Yutaka Kozu
- Department of Internal Medicine, Division of Respiratory Medicine, Nihon University School of Medicine, 30-1 Oyaguchikamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Tomoya Tateishi
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Masaharu Shinkai
- Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22 Higashioi, Shinagawa-ku, Tokyo, 140-8522, Japan
| | - Hironori Sagara
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Yasuo To
- Department of Pulmonary Medicine, International University of Health and Welfare School of Medicine, 852 Hatakeda, Narita, Chiba, 286-0124, Japan
| | - Yoko Ito
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Masaki Yamamoto
- Respiratory Disease Center, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Yoshihiro Yamamoto
- Department of Clinical Infectious Diseases, Toyama University Hospital, 2630 Sugitani, Toyama, 930-0152, Japan
| | - Toshiyuki Kita
- The Department of Respiratory Medicine, NHO Kanazawa Medical Center, 1-1 Shimoishibikimachi, Kanazawa, Ishikawa, 920-8650, Japan
| | - Yutaka Ito
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, 1 Mizuhochokawasumi, Mizuho-ku, Nagoya, 467-8602, Japan
| | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan
| | - Yukio Fujita
- Department of Respiratory Medicine, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8522, Japan
| | - Yoshihiro Funaki
- Division of Respiratory Medicine and Rheumatology, Faculty of Medicine, Tottori University, 36-1 Nishicho, Yonago, Tottori, 683-8504, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807- 8556, Japan
| | - Mari Yamasue
- Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Hasamamachiidaigaoka, Yufu, Oita, 879-5503, Japan
| | - Kosaku Komiya
- Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Hasamamachiidaigaoka, Yufu, Oita, 879-5503, Japan
| | - Satoko Kozawa
- Center for Asbestos-Related Diseases, Yokohama Rosai Hospital, 3211, Kozukuecho, Kohoku-ku, Yokohama, Kanagawa, 222-0036, Japan
| | - Hideaki Manabe
- Department of Respiratory Medicine, Sagamihara Kyodo Hospital, 4-3-1 Hashimotodai, Midori-ku, Sagamihara, Kanagawa, 252-5188, Japan
| | - Hironao Hozumi
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Tomoya Horiguchi
- Department of Respiratory Medicine, Fujita Health University School of Medicine, 1-98 Kutsukakechodengakugakubo, Toyoake, Aichi, 470-1192, Japan
| | - Takamasa Kitajima
- Respiratory Disease Center, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20 Ogimachi, Kita-ku, Osaka, 530-8480, Japan
| | - Yasushi Nakano
- Department of Respiratory Medicine, Kawasaki Municipal Ida Hospital, 2-27-1 Ida, Nakahara-ku, Kawasaki, Kanagawa, 211-0035, Japan
| | - Tetsutaro Nagaoka
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, Center Hospital of the National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Akinori Ebihara
- Department of Respiratory Medicine, Tokai University Tokyo Hospital, 1-2-5 Yoyogi, Shibuya-ku, Tokyo, 151-0053, Japan
| | - Masayoshi Kobayashi
- Department of Respiratory Medicine, Tokyo Metropolitan Bokutoh Hospital, 4-23-15 Kotobashi, Sumida-ku, Tokyo, 130-8575, Japan
| | - Koji Takayama
- Department of Respiratory Medicine, Musashino Red Cross Hospital, 1-26-1 Kyonancho, Musashino, Tokyo, 180-0023, Japan
| | - Torahiko Jinta
- Department of Pulmonary Medicine, St. Luke's International Hospital, 9-1 Akashicho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Toyomitsu Sawai
- Department of Respiratory Medicine, Nagasaki Harbor Medical Center, 6-39 Shinchimachi, Nagasaki, 850-0842, Japan
| | - Yuichi Fukuda
- Department of Respiratory Medicine, Sasebo City General Hospital, 9-3 Hirasecho, Sasebo, Nagasaki, 857-8511, Japan
| | - Takeshi Kaneko
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Kazuo Chin
- Department of Sleep Medicine and Respiratory Care, Division of Sleep Medicine, Nihon University of Medicine, 30-1 Oyaguchikamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Takashi Ogura
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Kanazawa-ku, Yokohama, Kanagawa, 236-0051, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan; Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Makoto Ishii
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Akihito Yokoyama
- Department of Respiratory Medicine and Allergology, Kochi Medical School, Kochi University, Oko-cho, Kohasu, Nankoku, Kochi, 783-8505, Japan
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Sawase A, Kitamura M, Morimoto M, Fukuda H, Uramatsu T, Katafuchi E, Yamashita H, Nakayama T, Mukae H, Nishino T. Renal tubular necrosis associated with anagrelide administration: a case report. CEN Case Rep 2024:10.1007/s13730-024-00881-3. [PMID: 38658458 DOI: 10.1007/s13730-024-00881-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 04/08/2024] [Indexed: 04/26/2024] Open
Abstract
A 62-year-old female patient with essential thrombocythemia experienced rapid renal dysfunction and was subsequently referred to our hospital. Further investigations did not reveal any significant abnormalities except for a slight increase in urinary β2-microglobulin levels. A renal biopsy was performed to investigate the cause of her renal dysfunction, revealing acute tubular necrosis, interstitial edema, and arteriosclerosis. No significant glomerular lesions were observed. Immunofluorescence staining and electron microscopy showed no abnormalities. She had been using anagrelide for 4 years, and her dosage was increased from 2.0 to 3.0 mg/day 10 months before her initial admission. Her renal function began to deteriorate 2 months after the anagrelide dosage increase. Although 0.625 mg of bisoprolol was initiated for tachycardia 3 months after the anagrelide dosage adjustment, we suspected that the acute tubular necrosis was associated with anagrelide administration. After transitioning from anagrelide to hydroxyurea and discontinuing bisoprolol, her renal function improved. This case suggests the importance of considering anagrelide as a potential cause of renal dysfunction in patients using this medication. Therefore, renal biopsy, combined with a comprehensive medical history, is crucial for evaluating the etiology of renal injury in such cases.
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Affiliation(s)
- Atsushi Sawase
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
- Department of Nephrology, Nagasaki Harbor Medical Center, Nagasaki, Japan
| | - Mineaki Kitamura
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
- Department of Nephrology, Nagasaki Harbor Medical Center, Nagasaki, Japan.
| | - Misato Morimoto
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Haruka Fukuda
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
- Department of Nephrology, Nagasaki Harbor Medical Center, Nagasaki, Japan
| | - Tadashi Uramatsu
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
- Department of Nephrology, Nijigaoka Hospital, Nagasaki, Japan
| | - Eisuke Katafuchi
- Department of Pathology, School of Medicine, University, of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hiroshi Yamashita
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
- Department of Nephrology, Nagasaki Harbor Medical Center, Nagasaki, Japan
| | - Toshiyuki Nakayama
- Department of Pathology, School of Medicine, University, of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomoya Nishino
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
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5
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Koga S, Takazono T, Namie H, Okuno D, Ito Y, Nakada N, Hirayama T, Takeda K, Ide S, Iwanaga N, Tashiro M, Sakamoto N, Watanabe A, Izumikawa K, Yanagihara K, Tanaka Y, Mukae H. Human Vγ9Vδ2 T cells exhibit antifungal activity against Aspergillus fumigatus and other filamentous fungi. Microbiol Spectr 2024; 12:e0361423. [PMID: 38426765 PMCID: PMC10986472 DOI: 10.1128/spectrum.03614-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 02/11/2024] [Indexed: 03/02/2024] Open
Abstract
Invasive aspergillosis (IA) and mucormycosis are life-threatening diseases, especially among immunocompromised patients. Drug-resistant Aspergillus fumigatus strains have been isolated worldwide, which can pose a serious clinical problem. As IA mainly occurs in patients with compromised immune systems, the ideal therapeutic approach should aim to bolster the immune system. In this study, we focused on Vγ9Vδ2 T cells that exhibit immune effector functions and examined the possibility of harnessing this unconventional T cell subset as a novel therapeutic modality for IA. A potent antifungal effect was observed when A. fumigatus (Af293) hyphae were challenged by Vγ9Vδ2 T cells derived from peripheral blood. In addition, Vγ9Vδ2 T cells exhibited antifungal activity against hyphae of all Aspergillus spp., Cunninghamella bertholletiae, and Rhizopus microsporus but not against their conidia. Furthermore, Vγ9Vδ2 T cells also exhibited antifungal activity against azole-resistant A. fumigatus, indicating that Vγ9Vδ2 T cells could be used for treating drug-resistant A. fumigatus. The antifungal activity of Vγ9Vδ2 T cells depended on cell-to-cell contact with A. fumigatus hyphae, and degranulation characterized by CD107a mobilization seems essential for this activity against A. fumigatus. Vγ9Vδ2 T cells could be developed as a novel modality for treating IA or mucormycosis. IMPORTANCE Invasive aspergillosis (IA) and mucormycosis are often resistant to treatment with conventional antifungal agents and have a high mortality rate. Additionally, effective antifungal treatment is hindered by drug toxicity, given that both fungal and human cells are eukaryotic, and antifungal agents are also likely to act on human cells, resulting in adverse effects. Therefore, the development of novel therapeutic agents specifically targeting fungi is challenging. This study demonstrated the antifungal activity of Vγ9Vδ2 T cells against various Aspergillus spp. and several Mucorales in vitro and discussed the mechanism underlying their antifungal activity. We indicate that adoptive immunotherapy using Vγ9Vδ2 T cells may offer a new therapeutic approach to IA.
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Affiliation(s)
- Satoru Koga
- Department of Respiratory Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hodaka Namie
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Daisuke Okuno
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Yuya Ito
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Nana Nakada
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
- Health Center, Nagasaki University, Nagasaki, Japan
| | - Tatsuro Hirayama
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
- Department of Pharmacotherapeutics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuaki Takeda
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Shotaro Ide
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
- Infectious Diseases Experts Training Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Naoki Iwanaga
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Masato Tashiro
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Akira Watanabe
- Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Koichi Izumikawa
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Yoshimasa Tanaka
- Center for Medical Innovation, Nagasaki University, Nagasaki, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
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6
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Tsuyuki T, Torigoe K, Shimizu M, Taira H, Sakamoto R, Abe S, Kuwatsuka S, Muta K, Mukae H, Nishino T. Dapagliflozin-induced drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Followed By Acute Interstitial Nephritis (AIN): A Case Report. Intern Med 2024:3347-23. [PMID: 38569906 DOI: 10.2169/internalmedicine.3347-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
A 78-year-old male was admitted to the hospital with acute renal failure and generalized erythema after starting dapagliflozin 10 mg/day for chronic kidney disease (CKD). A skin biopsy revealed superficial perivascular dermatitis with eosinophils. A renal biopsy revealed lymphocytic and eosinophilic infiltration of the interstitium, and focal tubulitis. The patient was diagnosed with a dapagliflozin-induced drug reaction with eosinophilia and systemic symptoms (DRESS), followed by acute interstitial nephritis (AIN), and prednisolone therapy was therefore initiated. The patient's renal function improved, and erythema disappeared. To our knowledge, this is the first report of DRESS caused by dapagliflozin, and the patient was successfully treated with prednisolone.
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Affiliation(s)
| | - Kenta Torigoe
- Department of Nephrology, Nagasaki University Hospital, Japan
| | | | - Hiroshi Taira
- Department of Nephrology, Nagasaki University Hospital, Japan
| | | | - Shinichi Abe
- Department of Nephrology, Nagasaki University Hospital, Japan
| | | | - Kumiko Muta
- Department of Nephrology, Nagasaki University Hospital, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Tomoya Nishino
- Department of Nephrology, Nagasaki University Hospital, Japan
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7
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Taniguchi H, Chavan SS, Chow A, Chan JM, Mukae H, Rudin CM, Sen T. Role of CD38 in anti-tumor immunity of small cell lung cancer. Front Immunol 2024; 15:1348982. [PMID: 38533509 PMCID: PMC10963403 DOI: 10.3389/fimmu.2024.1348982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/26/2024] [Indexed: 03/28/2024] Open
Abstract
Introduction Immune checkpoint blockade (ICB) with or without chemotherapy has a very modest benefit in patients with small cell lung cancer (SCLC). SCLC tumors are characterized by high tumor mutation burden (TMB) and low PD-L1 expression. Therefore, TMB and PD-L1 do not serve as biomarkers of ICB response in SCLC. CD38, a transmembrane glycoprotein, mediates immunosuppression in non-small cell lung cancer (NSCLC). In this brief report, we highlight the potential role of CD38 as a probable biomarker of immunotherapy response in SCLC. Methods We evaluated the role of CD38 as a determinant of tumor immune microenvironment in SCLC with bulk and single-cell transcriptomic analyses and protein assessments of clinical samples and preclinical models, including CD38 in vivo blockade. Results In SCLC clinical samples, CD38 levels were significantly correlated with the gene expression of the immunosuppressive markers FOXP3, PD-1 and CTLA-4. CD38 expression was significantly enhanced after chemotherapy and ICB treatment in SCLC preclinical models and clinical samples. A combination of cisplatin/etoposide, ICB, and CD38 blockade delayed tumor growth compared to cisplatin/etoposide. Conclusion Our study provides a preliminary but important direction toward exploring CD38 as a potential biomarker of ICB response and CD38 blockade as a combination strategy for chemo-immunotherapy in SCLC.
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Affiliation(s)
- Hirokazu Taniguchi
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Shweta S. Chavan
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Andrew Chow
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Joseph M. Chan
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Department of Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Charles M. Rudin
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Weill Cornell Medical College, New York, NY, United States
| | - Triparna Sen
- Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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8
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Fukuda Y, Horita N, Aga M, Kashizaki F, Hara Y, Obase Y, Niimi A, Kaneko T, Mukae H, Sagara H. Efficacy and safety of macrolide therapy for adult asthma: A systematic review and meta-analysis. Respir Investig 2024; 62:206-215. [PMID: 38211545 DOI: 10.1016/j.resinv.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/29/2023] [Accepted: 12/25/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND The evidence for macrolide therapy in adult asthma is not properly established and remains controversial. We conducted a systematic review and meta-analysis to examine the efficacy and safety of macrolide therapy for adult asthma. METHODS We searched randomized controlled trials from MEDLINE via the PubMed, CENTRAL, and Ichushi Web databases. The primary outcome was asthma exacerbation. The secondary outcomes were serious adverse events (including mortality), asthma-related quality of life (symptom scales, Asthma Control Questionnaire, and Asthma Quality of Life Questionnaire), rescue medication (puffs/day), respiratory function (morning peak expiratory flow, evening peak flow, and forced expiratory volume in 1 s), bronchial hyperresponsiveness, and minimum oral corticosteroid dose. Of the 805 studies, we selected seven studies for the meta-analysis, which was conducted using a random-effects model. SYSTEMATIC REVIEW REGISTRATION University Hospital Medical Information Network Clinical Trials Registry (UMIN000050824). RESULTS No significant difference between macrolide and placebo for asthma exacerbations was observed (risk ratio 0.71, 95 % confidence interval [CI] 0.46-1.09; p = 0.12). Macrolide therapy for adult asthma showed a significant improvement in rescue medication with short-acting beta-agonists (mean difference -0.41, 95 % CI -0.78 to -0.04; p = 0.03). Macrolide therapy did not show more serious adverse events (odd ratio 0.61, 95 % CI 0.34-1.10; p = 0.10) than those with placebo. The other secondary outcomes were not significantly different between the macrolide and placebo groups. CONCLUSIONS Macrolide therapy for adult asthma may be more effective than placebo and could be a treatment option.
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Affiliation(s)
- Yosuke Fukuda
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan; Department of Medicine, Division of Respiratory Medicine, Yamanashi Red Cross Hospital, Yamanashi, Japan.
| | - Nobuyuki Horita
- Chemotherapy Center, Yokohama City University Hospital, Kanagawa, Japan
| | - Masaharu Aga
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan
| | - Fumihiro Kashizaki
- Department of Respiratory Medicine, Yokohama Minami Kyosai Hospital, Kanagawa, Japan
| | - Yu Hara
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Yasushi Obase
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Akio Niimi
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Takeshi Kaneko
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hironori Sagara
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
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9
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Nagaoka K, Iwanaga N, Takegoshi Y, Murai Y, Kawasuji H, Miura M, Sato Y, Hatakeyama Y, Ito H, Kato Y, Shibayama N, Terasaki Y, Fujimura T, Takazono T, Kosai K, Sugano A, Morinaga Y, Yanagihara K, Mukae H, Yamamoto Y. Mortality risk factors and fulminant sub-phenotype in anaerobic bacteremia: a 10-year retrospective, multicenter, observational cohort study. Eur J Clin Microbiol Infect Dis 2024; 43:459-467. [PMID: 38172403 DOI: 10.1007/s10096-023-04743-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE During the last decade, the incidence of anaerobic bacteremia (AB) has been increasing. Patients with AB may develop complex underlying diseases, which can occasionally be accompanied by fatal or fulminant outcomes. However, the risk factors for AB-related mortality remain unclear. Herein, we sought to elucidate the risk factors for AB-related mortality. METHODS In this multicenter, retrospective, observational study, we enrolled patients with culture-proven AB from six tertiary hospitals in Japan, between January 2012 and December 2021. Data on patient and infection characteristics, laboratory findings, treatment, and outcome were collected, and their associations with mortality were analyzed. RESULTS A total of 520 participants were included. The 30-day mortality in the study cohort was 14.0% (73 patients), and malignant tumors were frequently observed comorbidities in 48% of the entire cohort. Multivariable logistic regression analysis showed a Charlson comorbidity score of > 6, serum creatinine level of > 1.17 mg/dL, and hypotension to be independent risk factors for 30-day mortality in AB (odds ratios [ORs] 2.12, 2.25, and 5.12, respectively; p < 0.05), whereas drainage significantly reduced this risk (OR, 0.28; p < 0.0001). Twelve patients (2.3% of the whole cohort and 16.4% of the deceased patients) presented with extremely rapid progression leading to fatal outcome, consistent with "fulminant AB." CONCLUSIONS This study identified acute circulatory dysfunction and performance of drainage as independent predictive factors for 30-day AB-related mortality and revealed the existence of a fulminant AB sub-phenotype. Our findings could serve as a practical guide to predict the clinical outcomes of AB.
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Affiliation(s)
- Kentaro Nagaoka
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan.
| | - N Iwanaga
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Y Takegoshi
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Y Murai
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan
| | - H Kawasuji
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan
| | - M Miura
- Department of Infection Control, Toyama Nishi General Hospital, Toyama, Japan
| | - Y Sato
- Department of Infection Control, Kamiichi General Hospital, Toyama, Japan
| | - Y Hatakeyama
- Department of Infection Control, Takaoka City Hospital, Toyama, Japan
| | - H Ito
- Department of Infection Control, Takaoka City Hospital, Toyama, Japan
| | - Y Kato
- Department of Infection Control, Toyama City Hospital, Toyama, Japan
| | - N Shibayama
- Department of Infection Control, Toyama City Hospital, Toyama, Japan
| | - Y Terasaki
- Department of Infection Control, Toyama City Hospital, Toyama, Japan
| | - T Fujimura
- Department of Infection Control, Toyama City Hospital, Toyama, Japan
| | - T Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - K Kosai
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - A Sugano
- Center for Clinical Research, Toyama University Hospital, Toyama, Japan
| | - Y Morinaga
- Department of Microbiology, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - K Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - H Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Y Yamamoto
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan
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10
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Hanada M, Ishimatsu Y, Sakamoto N, Ashizawa N, Yamanashi H, Sekino M, Izumikawa K, Mukae H, Ariyoshi K, Maeda T, Hara T, Sato S, Kozu R. Platypnoea-orthodeoxia syndrome in COVID-19 pneumonia patients: An observational study. Respir Investig 2024; 62:291-294. [PMID: 38281397 DOI: 10.1016/j.resinv.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 01/02/2024] [Accepted: 01/14/2024] [Indexed: 01/30/2024]
Abstract
This retrospective observational study aimed to assess the clinical characteristics of platypnea-orthodeoxia syndrome in patients with coronavirus disease 2019 (COVID-19) treated using mechanical ventilation or high-flow nasal canula. We analyzed 42 consecutive patients with COVID-19 from January 2020 to March 2022. The primary outcomes were the incidence of platypnea-orthodeoxia syndrome, the time with required long-term oxygen therapy, and short-term prognosis. Additionally, we examined the relationships between platypnea-orthodeoxia syndrome and COVID-19 severity, the time with long-term oxygen therapy, and short-term prognosis. Of the 42 included patients, 15 (35.7 %) had platypnea-orthodeoxia syndrome. Although mortality was not significantly different between both groups, the oxygen withdrawal rate in the platypnea-orthodeoxia syndrome group was significantly lower than that in the group without this syndrome. Clinical staff should be aware of the possibility of platypnea-orthodeoxia syndrome during positional changes in patients with COVID-19. Recognizing POS can improve early detection, countermeasures, and safety during physiotherapy.
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Affiliation(s)
- Masatoshi Hanada
- Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Physical Therapy Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yuji Ishimatsu
- Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Nobuyuki Ashizawa
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hirotomo Yamanashi
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Motohiro Sekino
- Department of Anesthesiology and Intensive Care Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Koichi Izumikawa
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Koya Ariyoshi
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Takahiro Maeda
- Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tetsuya Hara
- Department of Anesthesiology and Intensive Care Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shuntaro Sato
- Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Ryo Kozu
- Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Physical Therapy Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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11
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Ashizawa N, Kubo R, Tagawa R, Ito Y, Takeda K, Ide S, Iwanaga N, Fujita A, Tashiro M, Takazono T, Tanaka T, Nagaoka A, Yoshimura S, Ujifuku K, Koga T, Ishii K, Yamamoto K, Furumoto A, Izumikawa K, Yanagihara K, Mukae H. Efficacy of Intrathecal Isoniazid and Steroid Therapy in Refractory Tuberculous Meningitis. Intern Med 2024; 63:583-586. [PMID: 37344431 PMCID: PMC10937131 DOI: 10.2169/internalmedicine.1917-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 05/08/2023] [Indexed: 06/23/2023] Open
Abstract
Tuberculous meningitis is an infectious disease with high mortality. Literature describing intrathecal therapy for tuberculous meningitis is scarce. We herein report a case of refractory tuberculous meningitis in a 52-year-old woman with underlying neuropsychiatric systemic lupus erythematosus. Despite systemic treatment with anti-tuberculosis drugs and dexamethasone, her meningeal irritation deteriorated. Intrathecal isoniazid and prednisolone administration was therefore initiated, and the symptoms of severe meningeal irritation improved along with head magnetic resonance imaging and cerebrospinal fluid findings. This case report highlights the efficacy of intrathecal isoniazid and steroid injections for refractory tuberculous meningitis, particularly in patients with severe meningeal irritation.
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Affiliation(s)
- Nobuyuki Ashizawa
- Infection Control and Education Center, Nagasaki University Hospital, Japan
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
| | - Ryotaro Kubo
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
| | - Ryuta Tagawa
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
- Department of Respiratory Medicine, Sasebo City General Hospital, Japan
| | - Yuya Ito
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
| | - Kazuaki Takeda
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
| | - Shotaro Ide
- Infectious Diseases Experts Training Center, Nagasaki University Hospital, Japan
| | - Naoki Iwanaga
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
| | - Ayumi Fujita
- Infection Control and Education Center, Nagasaki University Hospital, Japan
| | - Masato Tashiro
- Infection Control and Education Center, Nagasaki University Hospital, Japan
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Takeshi Tanaka
- Infection Control and Education Center, Nagasaki University Hospital, Japan
| | - Atsushi Nagaoka
- Department of Neurology and Strokology, Nagasaki University Hospital, Japan
| | - Shunsuke Yoshimura
- Department of Neurology and Strokology, Nagasaki University Hospital, Japan
| | - Kenta Ujifuku
- Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Tomohiro Koga
- Division of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Koji Ishii
- Department of Anesthesiology, Nagasaki University School of Medicine, Japan
- Palliative Care Center, Nagasaki University Hospital, Japan
| | - Kazuko Yamamoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
- Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Japan
| | - Akitsugu Furumoto
- Infectious Diseases Experts Training Center, Nagasaki University Hospital, Japan
| | - Koichi Izumikawa
- Infection Control and Education Center, Nagasaki University Hospital, Japan
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
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12
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Yotsuyanagi H, Ohmagari N, Doi Y, Yamato M, Bac NH, Cha BK, Imamura T, Sonoyama T, Ichihashi G, Sanaki T, Tsuge Y, Uehara T, Mukae H. Efficacy and Safety of 5-Day Oral Ensitrelvir for Patients With Mild to Moderate COVID-19: The SCORPIO-SR Randomized Clinical Trial. JAMA Netw Open 2024; 7:e2354991. [PMID: 38335000 PMCID: PMC10858401 DOI: 10.1001/jamanetworkopen.2023.54991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/14/2023] [Indexed: 02/10/2024] Open
Abstract
Importance Treatment options for COVID-19 are warranted irrespective of the presence of risk factors for severe disease. Objective To assess the efficacy and safety of ensitrelvir in patients with mild to moderate COVID-19. Design, Setting, and Participants This phase 3 part of a phase 2/3, double-blind, placebo-controlled randomized clinical trial was conducted from February 10 to July 10, 2022, with a 28-day follow-up period, at 92 institutions in Japan, Vietnam, and South Korea. Patients (aged 12 to <70 years) with mild to moderate COVID-19 within 120 hours of positive viral test results were studied. Interventions Patients were randomized (1:1:1) to receive 125 mg of once-daily ensitrelvir (375 mg on day 1), 250 mg of once-daily ensitrelvir (750 mg on day 1), or placebo for 5 days. Main Outcomes and Measures The primary end point was the time to resolution of the composite of 5 characteristic symptoms of SARS-CoV-2 Omicron infection, assessed using a Peto-Prentice generalized Wilcoxon test stratified by vaccination history. Virologic efficacy and safety were also assessed. Results A total of 1821 patients were randomized, of whom 1030 (347 in the 125-mg ensitrelvir group, 340 in the 250-mg ensitrelvir group, and 343 in the placebo group) were randomized in less than 72 hours of disease onset (primary analysis population). The mean (SD) age in this population was 35.2 (12.3) years, and 552 (53.6%) were men. A significant difference was observed between the 125-mg ensitrelvir group and the placebo group (P = .04 with a Peto-Prentice generalized Wilcoxon test). The difference in median time was approximately 1 day between the 125-mg ensitrelvir group and the placebo group (167.9 vs 192.2 hours; difference, -24.3 hours; 95% CI, -78.7 to 11.7 hours). Adverse events were observed in 267 of 604 patients (44.2%) in the 125-mg ensitrelvir group, 321 of 599 patients (53.6%) in the 250-mg ensitrelvir group, and 150 of 605 patients (24.8%) in the placebo group, which included a decrease in high-density lipoprotein level (188 [31.1%] in the 125-mg ensitrelvir group, 231 [38.6%] in the 250-mg ensitrelvir group, and 23 [3.8%] in the placebo group). No treatment-related serious adverse events were reported. Conclusions and Relevance In this randomized clinical trial, 125-mg ensitrelvir treatment reduced the time to resolution of the 5 typical COVID-19 symptoms compared with placebo in patients treated in less than 72 hours of disease onset; the absolute difference in median time to resolution was approximately 1 day. Ensitrelvir demonstrated clinical and antiviral efficacy without new safety concerns. Generalizability to populations outside Asia should be confirmed. Trial Registration Japan Registry of Clinical Trials Identifier: jRCT2031210350.
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Affiliation(s)
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yohei Doi
- Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Departments of Microbiology and Infectious Diseases, Fujita Health University School of Medicine, Toyoake, Japan
| | - Masaya Yamato
- Infectious Diseases Center, Rinku General Medical Center, Izumisano, Japan
| | - Nguyen Hoang Bac
- Endoscopic Surgery Training Center, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Bong Ki Cha
- Department of Internal Medicine, Chung-Ang Medical Health Care System Hyundae Hospital, Gyeonggi-do, Republic of Korea
| | - Takumi Imamura
- Drug Development and Regulatory Science Division, Shionogi & Co, Ltd, Osaka, Japan
| | - Takuhiro Sonoyama
- Drug Development and Regulatory Science Division, Shionogi & Co, Ltd, Osaka, Japan
| | - Genki Ichihashi
- Drug Development and Regulatory Science Division, Shionogi & Co, Ltd, Osaka, Japan
| | - Takao Sanaki
- Research Division, Shionogi & Co, Ltd, Toyonaka, Japan
| | - Yuko Tsuge
- Drug Development and Regulatory Science Division, Shionogi & Co, Ltd, Osaka, Japan
| | - Takeki Uehara
- Drug Development and Regulatory Science Division, Shionogi & Co, Ltd, Osaka, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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13
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Akata K, Yamasaki K, Nemoto K, Ikegami H, Kawaguchi T, Noguchi S, Kawanami T, Fukuda K, Mukae H, Yatera K. Sarcoidosis Associated with Enlarged Mediastinal Lymph Nodes with the Detection of Streptococcus gordonii and Cutibacterium acnes Using a Clone Library Method. Intern Med 2024; 63:299-304. [PMID: 37258161 PMCID: PMC10864086 DOI: 10.2169/internalmedicine.1887-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/25/2023] [Indexed: 06/02/2023] Open
Abstract
A 77-year-old Japanese woman with mediastinal lymphadenopathy and uveitis was diagnosed with sarcoidosis. The bacterial flora in biopsied samples from mediastinal lymph nodes was analyzed using a clone library method with Sanger sequencing of the 16S rRNA gene, and Streptococcus gordonii (52 of 71 clones) and Cutibacterium acnes (19 of 71 clones) were detected. No previous study has conducted a bacterial floral analysis using the Sanger method for the mediastinal lymph node in sarcoidosis, making this case report the first to document the presence of S. gordonii and C. acnes in the mediastinal lymph node of a patient with sarcoidosis.
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Affiliation(s)
- Kentaro Akata
- Division of Infection Control and Prevention, University of Occupational and Environmental Health, Japan
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Kazuki Nemoto
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Hiroaki Ikegami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Takako Kawaguchi
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Shingo Noguchi
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Toshinori Kawanami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Kazumasa Fukuda
- Department of Microbiology, University of Occupational and Environmental Health, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
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14
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Ikushima I, Yamasaki K, Tahara M, Nemoto K, Akata K, Ikegami H, Nishida C, Muramatsu K, Fujino Y, Matsuda S, Fushimi K, Mukae H, Yatera K. Epidemiologic evaluation of pulmonary paragonimiasis in Japan using a Japanese nationwide administrative database. J Infect Chemother 2024:S1341-321X(24)00007-2. [PMID: 38219980 DOI: 10.1016/j.jiac.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/05/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Paragonimiasis is a parasitic disease primarily contracted through consumption of undercooked freshwater crustaceans or wild boar meat. Large-scale nationwide epidemiological data on paragonimiasis are lacking. In this study, we aimed to investigate the nationwide epidemiology of hospitalized patients with paragonimiasis in Japan using a comprehensive nationwide Japanese administrative database. METHODS We evaluated the Japanese Diagnosis Procedure Combination (DPC) data of patients diagnosed with pulmonary paragonimiasis between April 1, 2012 and March 30, 2020. The patients' address and information, including age, sex, treatment (medication: praziquantel; surgery: open thoracotomy or intracranial mass extirpation), Japan coma scale, comorbidities, and length of hospital stay, were extracted. RESULTS Of the 49.6 million hospitalized patients, data were extracted on 73 patients with paragonimiasis, of whom 36 were male and 37 were female. The mean age was 49.7 years and the mean length of stay was 12.5 days. The most frequent comorbidity was pleural effusion (31.5 %), followed by pneumothorax (13.7 %). The sites of ectopic paragonimiasis in organs other than the lung included the liver (5.5 %), skin (4.1 %), and brain (2.7 %). Geographically, most patients were from the Kyushu region (54.8 %), followed by the Kanto region (22.0 %). Fukuoka Prefecture had the highest number of patients (22.0 %) by prefecture. During the study period, an average of 9.1 patients/year were hospitalized with lung paragonimiasis in Japan. CONCLUSION Paragonimiasis has not completely disappeared in Japan; thus, physicians should be aware of paragonimiasis in the Kyushu region, especially in the Fukuoka Prefecture.
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Affiliation(s)
- Issei Ikushima
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
| | - Masahiro Tahara
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kazuki Nemoto
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kentaro Akata
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Hiroaki Ikegami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Chinatsu Nishida
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Keiji Muramatsu
- Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Shinya Matsuda
- Department of Environmental Epidemiology, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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15
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Takazono T, Hosogaya N, Fukushima K, Morio R, Irifune S, Miyamura T, Harada Y, Nagayoshi Y, Kondo A, Mihara T, Fukuda Y, Sasaki E, Sawai T, Imamura Y, Morikawa T, Futsuki Y, Inoue Y, Fukushima K, Suyama N, Tanaka H, Hanaka T, Shimabukuro I, Hata R, Ota K, Morimoto S, Nakada N, Ito Y, Yoshida M, Takeda K, Ide S, Iwanaga N, Nemoto K, Funada M, Izumikawa K, Yatera K, Yanagihara K, Mukae H. Efficacy and safety of lascufloxacin for nursing- and healthcare-associated pneumonia: A single-arm, open-label clinical trial. J Infect Chemother 2024:S1341-321X(24)00005-9. [PMID: 38190963 DOI: 10.1016/j.jiac.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/06/2023] [Accepted: 01/04/2024] [Indexed: 01/10/2024]
Abstract
BACKGROUND Nursing- and healthcare-associated pneumonia (NHCAP) constitutes most of the pneumonia in elderly patients including aspiration pneumonia in Japan. Lascufloxacin (LSFX) possesses broad antibacterial activity against respiratory pathogens, such as Streptococcus spp. And anaerobes inside the oral cavity. However, the efficacy and safety of LSFX in NHCAP treatment remains unknown. We aimed to evaluate the efficacy and safety of LSFX tablets in the treatment of patients with NHCAP. METHODS In this single-arm, open-label, uncontrolled study, LSFX was administered to patients with NHCAP at 24 facilities. The study participants were orally administered 75 mg LSFX once daily for 7 days. The primary endpoint was the clinical efficacy at the time of test of cure (TOC). The secondary endpoints included clinical efficacy at the time of end of treatment (EOT), early clinical efficacy, microbiological efficacy, and safety analysis. RESULT During the study period, 75 patients provided written informed consent to participate and were included. Finally, 56 and 71 patients were eligible for clinical efficacy and safety analyses, respectively. The median age of the patients was significantly high at 86 years. All patients were classified as having moderate disease severity using the A-DROP scoring system. LSFX tablets demonstrated high efficacy rates of 78.6 % at TOC and 89.3 % at EOT. The risk factors for resistant bacteria or aspiration pneumonia did not affect clinical efficacy. No severe adverse events associated with the study drugs were observed. CONCLUSION Oral LSFX is an acceptable treatment option for moderate NHCAP in elderly patients who can take oral medications.
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Affiliation(s)
- Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naoki Hosogaya
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan; Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Koki Fukushima
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Internal Medicine, Izumikawa Hospital, Nagasaki, Japan
| | - Ryosuke Morio
- Department of Internal Medicine, Izumikawa Hospital, Nagasaki, Japan; Department of Respiratory Medicine, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Satoshi Irifune
- Department of Internal Medicine, Shimabara Hospital, Nagasaki, Japan
| | - Takuto Miyamura
- Department of Internal Medicine, Shimabara Hospital, Nagasaki, Japan
| | - Yosuke Harada
- Department of Internal Medicine, Nagasaki Kouseikai Hospital, Nagasaki, Japan; Department of Internal Medicine, Nagasaki Saiseikai Hospital, Nagasaki, Japan
| | - Yosuke Nagayoshi
- Department of Internal Medicine, Japanese Red Cross Nagasaki Genbaku Isahaya Hospital, Nagasaki, Japan
| | - Akira Kondo
- Department of Internal Medicine, Japanese Red Cross Nagasaki Genbaku Isahaya Hospital, Nagasaki, Japan
| | - Tomo Mihara
- Department of Internal Medicine, Japan Community Healthcare Organization Isahaya General Hospital, Nagasaki, Japan
| | - Yuichi Fukuda
- Department of Respiratory Medicine, Sasebo City General Hospital, Nagasaki, Japan
| | - Eisuke Sasaki
- Department of Respiratory Medicine, Ureshino Medical Center, Saga, Japan
| | - Toyomitsu Sawai
- Department of Respiratory Medicine, Nagasaki Harbor Medical Center, Nagasaki, Japan
| | - Yoshifumi Imamura
- Department of Internal Medicine, Nagasaki Memorial Hospital, Nagasaki, Japan
| | - Toru Morikawa
- Department of Internal Medicine, Nagasaki Memorial Hospital, Nagasaki, Japan
| | - Yoji Futsuki
- Department of Internal Medicine, Nagasaki Saiseikai Hospital, Nagasaki, Japan
| | - Yuichi Inoue
- Department of Internal Medicine, Japanese Aino Memorial Hospital, Nagasaki, Japan
| | - Kiyoyasu Fukushima
- Department of Internal Medicine, Japanese Red Cross Nagasaki Genbaku Isahaya Hospital, Nagasaki, Japan
| | - Naofumi Suyama
- Department of Internal Medicine, Izumikawa Hospital, Nagasaki, Japan
| | - Hikaru Tanaka
- Department of Internal Medicine, Senju Hospital, Nagasaki, Japan
| | - Tetsuya Hanaka
- Department of Respiratory Medicine, Kurate Hospital, Fukuoka, Japan
| | | | - Ryosuke Hata
- Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health, Fukuoka, Japan
| | - Kenji Ota
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Shimpei Morimoto
- Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Nana Nakada
- Health Center, Nagasaki University, Nagasaki, Japan
| | - Yuya Ito
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Internal Medicine, Nagasaki Goto Chuoh Hospital, Nagasaki, Japan
| | - Masataka Yoshida
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Respiratory Medicine, Sasebo City General Hospital, Nagasaki, Japan
| | - Kazuaki Takeda
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Shotaro Ide
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Naoki Iwanaga
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Kazuki Nemoto
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Midori Funada
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Koichi Izumikawa
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.
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16
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Ota K, Sakai H, Sasaki D, Mitsumoto-Kaseida F, Sakamoto K, Kosai K, Hasegawa H, Takazono T, Izumikawa K, Mukae H, Tun MMN, Morita K, Yanagihara K. Rapid increase in salivary IgA and broad recognition of spike protein following SARS-CoV-2 vaccination. Virus Res 2024; 339:199294. [PMID: 38056502 PMCID: PMC10749273 DOI: 10.1016/j.virusres.2023.199294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 11/24/2023] [Accepted: 12/03/2023] [Indexed: 12/08/2023]
Abstract
Saliva is a key component of mucosal immunity, which protects the oral cavity from viral infections. However, salivary immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in terms of immunoglobulin dynamics and recognition, have not been investigated sufficiently. In this study, saliva samples were collected from individuals that received SARS-CoV-2 vaccine, and immunoglobulin G (IgG), IgM, and IgA against whole spike protein and S1 protein were measured. IgA against whole spike protein increased significantly following vaccination, while IgA against S1 protein did not. Of note, the IgA response was evident two weeks after the first vaccine dose and continued to rise thereafter. On the contrary, IgG antibodies against S1 increased significantly at four weeks after vaccination. These results reveal the dynamics and recognition antigens of immunoglobulins in saliva, indicating the function of IgA in the mucosal immune system. These findings may pave the way for further studies on mucosal immune response induced by vaccination.
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Affiliation(s)
- Kenji Ota
- Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki 852-8501, Japan.
| | - Hironori Sakai
- CellSpect Co. Ltd., 2-4, Kita Iioka, Morioka, Iwate 020-0857, Japan
| | - Daisuke Sasaki
- Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki 852-8501, Japan
| | - Fujiko Mitsumoto-Kaseida
- Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki 852-8501, Japan
| | - Kei Sakamoto
- Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki 852-8501, Japan
| | - Kosuke Kosai
- Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki 852-8501, Japan
| | - Hiroo Hasegawa
- Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki 852-8501, Japan
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki 852-8501, Japan
| | - Koichi Izumikawa
- Infection Control and Education Center, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki 852-8501, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki 852-8501, Japan
| | - Mya Myat Ngwe Tun
- Department of Virology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4, Sakamoto, Nagasaki 852-8102, Japan
| | - Kouichi Morita
- Department of Virology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4, Sakamoto, Nagasaki 852-8102, Japan; Dejima Infectious Disease Research Alliance, Nagasaki University, 1-12-4, Sakamoto, Nagasaki 852-8102, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki 852-8501, Japan
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17
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Ideguchi S, Yamamoto K, Takazono T, Fukuda Y, Tashiro T, Shizukuishi S, Chang B, Ogawa M, Izumikawa K, Yanagihara K, Yatera K, Mukae H. Clinical features relating to pneumococcal colony phase variation in hospitalized adults with pneumonia. J Med Microbiol 2024; 73. [PMID: 38189377 DOI: 10.1099/jmm.0.001784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
Background. Streptococcus pneumoniae is a major causative bacteria of pneumonia and invasive pneumococcal disease (IPD); however, the mechanisms underlying its severity and invasion remain to be defined. Pneumococcal colonies exhibit opaque and transparent opacity phase variations, which have been associated with invasive infections and nasal colonization, respectively, in animal studies. This study evaluated the relationship between the opacity of pneumococcal colonies and the clinical presentation of pneumococcal pneumonia.Methods. This retrospective study included adult patients hospitalized with pneumococcal pneumonia between 2012 and 2019 at four tertiary medical institutions. Pneumococcal strains from lower respiratory tract specimens were determined for their serotypes and microscopic colony opacity, and the association between the opacity phase and the severity of pneumonia was evaluated. Serotypes 3 and 37 with mucoid colony phenotypes were excluded from the study because their colony morphologies were clearly different.Results. A total of 92 patients were included. Most patients were older adults (median age: 72 years) and males (67 %), and 59 % had community-acquired pneumonia. Of the 92 patients, 41 (45 %), 12 (13 %), and 39 (42 %) patients had opaque, transparent, and mixed variants in their pneumococcal colony, respectively. The opaque and non-opaque pneumococcal variants had no statistically significant difference in patient backgrounds. Although the pneumonia severity index score did not differ between the opaque and non-opaque groups, the rate of bacteremia was significantly higher in the opaque group than in the non-opaque group. Serotype distribution was similar between the groups.Conclusions. Opaque pneumococcal variants may cause pneumonia and invasive diseases in humans. This study could help elucidate IPD, and opacity assessment may serve as a predictor for IPD.
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Affiliation(s)
- Shuhei Ideguchi
- First Department of Internal Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Okinawa, Japan
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Kazuko Yamamoto
- First Department of Internal Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Okinawa, Japan
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Yuichi Fukuda
- Department of Respiratory Medicine, Sasebo City General Hospital, Nagasaki, Japan
| | - Takahiro Tashiro
- Department of Respiratory Medicine, Kumamoto Chuo Hospital, Kumamoto, Japan
| | - Sayaka Shizukuishi
- Department of Bacteriology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Bin Chang
- Department of Bacteriology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Michinaga Ogawa
- Department of Bacteriology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Koichi Izumikawa
- Department of Infection Control and Education Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, Hospital of the University of Occupational and Environmental Health, Japan, Fukuoka, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
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18
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Namie H, Takazono T, Hidaka Y, Morimoto S, Ito Y, Nakada N, Ashizawa N, Hirayama T, Takeda K, Iwanaga N, Tashiro M, Hosogaya N, Tanaka T, Fushimi K, Yanagihara K, Mukae H, Izumikawa K. The prognostic factors for cryptococcal meningitis in non-human immunodeficiency virus patients: An observational study using nationwide database. Mycoses 2024; 67:e13658. [PMID: 37807638 DOI: 10.1111/myc.13658] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 09/22/2023] [Accepted: 09/26/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Cryptococcal meningitis (CM) is an invasive fungal infection with a poor prognosis that often occurs in both healthy individuals and compromised hosts, such as patients infected with human immunodeficiency virus (HIV). Unlike CM in HIV patients, evidence regarding CM in non-HIV patients is limited to small retrospective studies. OBJECTIVE To identify the pretreatment prognostic factors for CM in non-HIV patients. METHODS We conducted a large retrospective analysis of CM in non-HIV patients using data from a nationwide Japanese database. The study included hospitalized patients diagnosed with CM between 1 April 2010 and 31 March 2017. All-cause mortality was compared between patients with CM with and without HIV infection. Poor diagnostic factors were analysed in the non-HIV CM group. RESULTS Overall, 533 (64 HIV and 469 non-HIV) patients met the criteria. The mortality rate at 90 days was significantly lower in the HIV group (6.3% vs. 25.4% p = .0002). In a logistic regression analysis of the non-HIV group, age ≥ 65 y (odds ratio [OR] 2.37, 95% CI 1.17-4.78), impaired consciousness (Japan Coma Scale ≥1) (OR 2.25, 95% CI 1.29-3.93), haemodialysis (OR 3.53, 95% CI 1.12-11.20) and previous corticosteroid usage (OR 2.40, 95% CI 1.37-4.19) were associated with poor prognosis at 30 days after diagnosis. CONCLUSION More caution is suggested when treating non-HIV with CM in older patients with impaired consciousness, previous corticosteroid usage and haemodialysis.
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Affiliation(s)
- Hotaka Namie
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takahiro Takazono
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Yusuke Hidaka
- Department of General Internal Medicine, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Shimpei Morimoto
- Innovation Platform & Office for Precision Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Yuya Ito
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Nana Nakada
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
- Health Center, Nagasaki University, Nagasaki, Japan
| | - Nobuyuki Ashizawa
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Tatsuro Hirayama
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
- Department of Pharmacotherapeutics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuaki Takeda
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Naoki Iwanaga
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Masato Tashiro
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Naoki Hosogaya
- Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Takeshi Tanaka
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Koichi Izumikawa
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki, Japan
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Yoshida Y, Torigoe K, Sakamoto R, Abe S, Muta K, Mukae H, Nishino T. A Case of Combination of IgA Nephropathy and Interstitial Nephritis After COVID-19 Vaccination. Cureus 2024; 16:e52981. [PMID: 38406008 PMCID: PMC10894454 DOI: 10.7759/cureus.52981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2024] [Indexed: 02/27/2024] Open
Abstract
A 66-year-old male presented with renal dysfunction. At the time of presentation, his serum creatinine (sCr) was 2.55 mg/dL, estimated glomerular filtration rate (eGFR) was 20.93 ml/min/1.73 m2, urinary red blood cell (RBC) was 30-49/high power field, and urine protein-creatinine ratio was 0.43 g/gCr. The patient had no urinalysis abnormalities or renal dysfunction within the year prior to presentation but had gross hematuria after the third and fourth coronavirus disease 2019 (COVID-19) vaccinations. Therefore, immunoglobulin A nephropathy (IgAN) was suspected and a percutaneous renal biopsy was performed. Renal pathology confirmed IgAN and interstitial nephritis and glucocorticoid therapy was initiated. Glucocorticoids improved renal function, and microscopic hematuria resolved. Although previous reports have shown that the COVID-19 vaccine induces various renal diseases, complications associated with these two renal diseases are rare. In this case, while IgAN was suspected based on episodes of gross hematuria after vaccination, renal biopsy confirmed it and also revealed interstitial nephritis.
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Affiliation(s)
- Yuki Yoshida
- Nephrology, Nagasaki University Hospital, Nagasaki, JPN
| | - Kenta Torigoe
- Nephrology, Nagasaki University Hospital, Nagasaki, JPN
| | | | - Shinichi Abe
- Nephrology, Nagasaki University Hospital, Nagasaki, JPN
| | - Kumiko Muta
- Nephrology, Nagasaki University Hospital, Nagasaki, JPN
| | - Hiroshi Mukae
- Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JPN
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20
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Mori N, Mikamo H, Mukae H, Yanagihara K, Kunishima H, Sasaki J, Yotsuyanagi H. Influence of the coronavirus infectious disease 2019 pandemic on infectious disease practice and infection control in Japan: A web questionnaire survey. J Infect Chemother 2024; 30:1-6. [PMID: 37717609 DOI: 10.1016/j.jiac.2023.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/02/2023] [Accepted: 09/15/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION Infection and mortality rates caused by the coronavirus infectious disease 2019 (COVID-19) pandemic were high. However, the influence of the COVID-19 pandemic on the clinical burden in medical facilities remains to be clarified in Japan. MATERIALS AND METHODS This study used a questionnaire-based web survey to clarify how the COVID-19 pandemic affected infectious disease practice and infection control. The questionnaire was sent to healthcare professionals at nationwide medical facilities between January 13, 2023, and February 15, 2023. RESULTS Responses were obtained from 1784 healthcare professionals throughout Japan. Hospital management of COVID-19 patients was the responsibility of 96.5% of respondents. Furthermore, 75.1% had experienced nosocomial spread of COVID-19. Manuals and infection control measures for COVID-19 have been arranged in most facilities. In many facilities, the timing of an infected employee's return to work was determined in accordance with the isolation period for coronavirus-positive patients with symptoms established by the Ministry of Health, Labor and Welfare in Japan. Approximately 30% of respondents reported that caring for COVID-19 patients, including the use of personal protective equipment, was their most stressful job. Approximately 50% of the respondents reported an increase in overtime hours. Approximately 90% of facilities are now capable of performing COVID-19 testing onsite. CONCLUSION Infection control for COVID-19 has been improved, and testing equipment for SARS-CoV-2 has been prepared. Patient care-related burdens and burdens caused by having to compensate for vacancies due to infected staff members have increased. In the future, a reduction in workload and role sharing should be considered.
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Affiliation(s)
- Nobuaki Mori
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan.
| | - Hiroshi Mukae
- Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Hiroyuki Kunishima
- Department of Infectious Diseases, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Junichi Sasaki
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hiroshi Yotsuyanagi
- Division of Infectious Diseases, Advanced Clinical Research Center, Institute of Medical Science, University of Tokyo, Tokyo, Japan
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21
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Oguma T, Ishiguro T, Kamei K, Tanaka J, Suzuki J, Hebisawa A, Obase Y, Mukae H, Tanosaki T, Furusho S, Kurokawa K, Watai K, Matsuse H, Harada N, Nakamura A, Shibayama T, Baba R, Fukunaga K, Matsumoto H, Ohba H, Sakamoto S, Suzuki S, Tanaka S, Yamada T, Yamasaki A, Fukutomi Y, Shiraishi Y, Toyotome T, Fukunaga K, Shimoda T, Konno S, Taniguchi M, Tomomatsu K, Okada N, Asano K. Clinical characteristics of allergic bronchopulmonary mycosis caused by Schizophyllum commune. Clin Transl Allergy 2024; 14:e12327. [PMID: 38282191 PMCID: PMC10758016 DOI: 10.1002/clt2.12327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 12/03/2023] [Accepted: 12/13/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Allergic bronchopulmonary mycosis (ABPM) is an allergic disease caused by type I and type III hypersensitivity to environmental fungi. Schizophyllum commune, a basidiomycete fungus, is one of the most common fungi that causes non-Aspergillus ABPM. OBJECTIVE Herein, we attempted to clarify the clinical characteristics of ABPM caused by S. commune (ABPM-Sc) compared with those of allergic bronchopulmonary aspergillosis (ABPA). METHODS Patients with ABPM-Sc or ABPA were recruited from a nationwide survey in Japan, a multicenter cohort, and a fungal database at the Medical Mycology Research Center of Chiba University. The definition of culture-positive ABPM-Sc/ABPA is as follows: (1) fulfills five or more of the 10 diagnostic criteria for ABPM proposed by Asano et al., and (2) positive culture of S. commune/Aspergillus spp. in sputum, bronchial lavage fluid, or mucus plugs in the bronchi. RESULTS Thirty patients with ABPM-Sc and 46 with ABPA were recruited. Patients with ABPM-Sc exhibited less severe asthma and presented with better pulmonary function than those with ABPA (p = 0.008-0.03). Central bronchiectasis was more common in ABPM-Sc than that in ABPA, whereas peripheral lung lesions, including infiltrates/ground-glass opacities or fibrotic/cystic changes, were less frequent in ABPM-Sc. Aspergillus fumigatus-specific immunoglobulin (Ig)E was negative in 10 patients (34%) with ABPM-Sc, who demonstrated a lower prevalence of asthma and levels of total serum IgE than those with ABPM-Sc positive for A. fumigatus-specific IgE or ABPA. CONCLUSIONS Clinical characteristics of ABPM-Sc, especially those negative for A. fumigatus-specific IgE, differed from those of ABPA.
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22
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Okamoto M, Fujimoto K, Johkoh T, Kawaguchi A, Mukae H, Sakamoto N, Ogura T, Ikeda S, Kondoh Y, Yamano Y, Komiya K, Umeki K, Nishikiori H, Tanino Y, Tsuda T, Arai N, Komatsu M, Sakamoto S, Yatera K, Inoue Y, Miyazaki Y, Hashimoto S, Shimizu Y, Hozumi H, Ohnishi H, Handa T, Hattori N, Kishaba T, Kato M, Inomata M, Ishii H, Hamada N, Konno S, Zaizen Y, Azuma A, Suda T, Izuhara K, Hoshino T. A prospective cohort study of periostin as a serum biomarker in patients with idiopathic pulmonary fibrosis treated with nintedanib. Sci Rep 2023; 13:22977. [PMID: 38151520 PMCID: PMC10752870 DOI: 10.1038/s41598-023-49180-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 12/05/2023] [Indexed: 12/29/2023] Open
Abstract
This study investigated the utility of periostin, a matricellular protein, as a prognostic biomarker in patients with idiopathic pulmonary fibrosis (IPF) who received nintedanib. Monomeric and total periostin levels were measured by enzyme-linked immunosorbent assay in 87 eligible patients who participated in a multicenter prospective study. Forty-three antifibrotic drug-naive patients with IPF described in previous studies were set as historical controls. Monomeric and total periostin levels were not significantly associated with the change in forced vital capacity (FVC) or diffusing capacity of the lungs for carbon monoxide (DLCO) during any follow-up period. Higher monomeric and total periostin levels were independent risk factors for overall survival in the Cox proportional hazard model. In the analysis of nintedanib effectiveness, higher binarized monomeric periostin levels were associated with more favorable suppressive effects on decreased vital capacity (VC) and DLCO in the treatment group compared with historical controls. Higher binarized levels of total periostin were associated with more favorable suppressive effects on decreased DLCO but not VC. In conclusion, higher periostin levels were independently associated with survival and better therapeutic effectiveness in patients with IPF treated with nintedanib. Periostin assessments may contribute to determining therapeutic strategies for patients with IPF.
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Affiliation(s)
- Masaki Okamoto
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
- Department of Respirology, NHO Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-0065, Japan.
| | - Kiminori Fujimoto
- Department of Radiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Takeshi Johkoh
- Department of Radiology, Kansai Rosai Hospital, Inabasou 3-1-69, Amagasaki, Hyogo, 660-0064, Japan
| | - Atsushi Kawaguchi
- Education and Research Center for Community Medicine, Faculty of Medicine, Saga Medical School, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Takashi Ogura
- Division of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Yokohama, Kanagawa-ku, Kanagawa, 236-0051, Japan
| | - Satoshi Ikeda
- Division of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Yokohama, Kanagawa-ku, Kanagawa, 236-0051, Japan
| | - Yasuhiro Kondoh
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, 160 Nishioiwake, Seto, Aichi, 489-0065, Japan
| | - Yasuhiko Yamano
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, 160 Nishioiwake, Seto, Aichi, 489-0065, Japan
| | - Kosaku Komiya
- Respiratory Medicine and Infectious Diseases, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan
| | - Kenji Umeki
- Department of Respiratory Medicine, Tenshindo Hetsugi Hospital, 5956 Nakahetsugi, Oita, 879-7761, Japan
| | - Hirotaka Nishikiori
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, South-1-West-16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Yoshinori Tanino
- Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan
| | - Toru Tsuda
- Kirigaoka Tsuda Hospital, 3-9-20 Kirigaoka, Kitakyushu, Fukuoka, 802-0052, Japan
| | - Naoki Arai
- Department of Respiratory Medicine, National Hospital Organization Ibarakihigashi National Hospital, 825 Terunuma, Tokai-mura, Ibaraki, 319-1113, Japan
| | - Masamichi Komatsu
- First Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Susumu Sakamoto
- Department of Respiratory Medicine, Toho University Omori Medical Center, 6-11-1 Omorinishi, Tokyo, 143-8541, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Yoshikazu Inoue
- Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, 1180 Nagasone-cho, Sakai, Osaka, 591-8555, Japan
| | - Yasunari Miyazaki
- Department of Respiratory Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Tokyo, 113-8510, Japan
| | - Seishu Hashimoto
- Department of Respiratory Medicine, Tenri Hospital, 200 Mishima-cho, Tenri, Nara, 632-8552, Japan
| | - Yasuo Shimizu
- Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan
| | - Hironao Hozumi
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Hiroshi Ohnishi
- Department of Respiratory Medicine and Allergology, Kochi Medical School, Kochi University, 185-1 Kohasu, Nankoku, Kochi, 783-8505, Japan
| | - Tomohiro Handa
- Department of Advanced Medicine for Respiratory Failure, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Noboru Hattori
- Department of Molecular and Internal Medicine, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Tomoo Kishaba
- Department of Respiratory Medicine, Okinawa Chubu Hospital, 281 Miyazato, Uruma, Okinawa, 904-2293, Japan
| | - Motoyasu Kato
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Tokyo, 113-8421, Japan
| | - Minoru Inomata
- Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Tokyo, 150-8935, Japan
| | - Hiroshi Ishii
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyouin, Chikushino, Fukuoka, 818-8502, Japan
| | - Naoki Hamada
- Department of Respiratory Medicine, Fukuoka University Hospital, 7-45-1 Nanakuma, Fukuoka, 814-0180, Japan
| | - Satoshi Konno
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, N15W7 Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Yoshiaki Zaizen
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Arata Azuma
- Respirology and Clinical Research Center, Mihara General Hospital and Nippon Medical School, Tokorozawa, Saitama, 359-0045, Japan
| | - Takafumi Suda
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Kenji Izuhara
- Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Tomoaki Hoshino
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
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23
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Hayashi F, Akagi K, Taniguchi H, Matsutake T, Kawahara H, Sekine I, Gyotoku H, Takemoto S, Soda H, Ashizawa K, Mukae H. TIM-3 expression induces resistance to PD-1 inhibitor in G-CSF-producing lung spindle cell carcinoma: A case report. Thorac Cancer 2023; 14:3556-3560. [PMID: 37926435 PMCID: PMC10733156 DOI: 10.1111/1759-7714.15149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/20/2023] [Accepted: 10/21/2023] [Indexed: 11/07/2023] Open
Abstract
Lung spindle cell carcinoma is an aggressive subtype of pleomorphic lung cancer resistant to cytotoxic chemotherapy. Programmed cell death-1 (PD-1) inhibitors have been reported to have clinical effects in patients with spindle cell carcinoma; however, the resistance mechanism to PD-1 inhibitors is yet to be fully elucidated. Herein, we report the case of an 88-year-old man with G-CSF-producing spindle cell carcinoma who acquired resistance to PD-1/PD-ligand 1 (L1) inhibitor in an early setting after a remarkable response. A histopathological review of the resistant specimen revealed a low count of CD8+ T cells and a predominant presence of M2 and TIM-3+ macrophages, indicating the presence of an immunosuppressive microenvironment. Our findings suggest a novel resistance mechanism to PD-1/PD-L1 inhibitors in G-CSF-producing spindle cell carcinoma.
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Affiliation(s)
- Fumiko Hayashi
- Department of Respiratory MedicineNagasaki University HospitalNagasakiJapan
| | - Kazumasa Akagi
- Department of Respiratory MedicineNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
- Clinical Oncology CenterNagasaki University HospitalNagasakiJapan
| | - Hirokazu Taniguchi
- Department of Respiratory MedicineNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
- Clinical Oncology CenterNagasaki University HospitalNagasakiJapan
| | | | - Hiromi Kawahara
- Department of Internal MedicineKouseikai HospitalNagasakiJapan
| | - Ichiro Sekine
- Department of PathologyKouseikai HospitalNagasakiJapan
| | - Hiroshi Gyotoku
- Department of Respiratory MedicineNagasaki University HospitalNagasakiJapan
- Department of Respiratory MedicineNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
| | - Shinnosuke Takemoto
- Department of Respiratory MedicineNagasaki University HospitalNagasakiJapan
- Department of Respiratory MedicineNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
| | - Hiroshi Soda
- Department of Respiratory MedicineSasebo City General HospitalSaseboJapan
| | - Kazuto Ashizawa
- Clinical Oncology CenterNagasaki University HospitalNagasakiJapan
- Department of Clinical OncologyNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
| | - Hiroshi Mukae
- Department of Respiratory MedicineNagasaki University HospitalNagasakiJapan
- Department of Respiratory MedicineNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
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24
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Yamaguchi K, Kitamura M, Takazono T, Hashiguchi J, Funakoshi S, Mukae H, Nishino T. Prognoses of patients undergoing hemodialysis administered 23-valent pneumococcal polysaccharide versus 13-valent pneumococcal protein conjugate vaccines. J Infect Chemother 2023; 29:1126-1131. [PMID: 37604429 DOI: 10.1016/j.jiac.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 07/22/2023] [Accepted: 08/14/2023] [Indexed: 08/23/2023]
Abstract
INTRODUCTION Sequential vaccination with the 13-valent pneumococcal protein conjugate vaccine (PCV13) and 23-valent pneumococcal polysaccharide vaccine (PPSV23) is recommended for patients undergoing hemodialysis; however, evidence for the efficacy of these pneumococcal vaccines for patients undergoing hemodialysis is limited to a single dose. We aimed to evaluate the prognosis of patients undergoing hemodialysis who received vaccination with PPSV23 alone versus sequential vaccination with PCV13 and PPSV23. METHODS Patients undergoing hemodialysis who were vaccinated with PPSV23 alone (PPSV23 group) or PCV13 followed by PPSV23 (PCV13+PPSV23 group) between 2014 and 2016 were included; the observation period was three years from the first injection. Patients who underwent hemodialysis between 2011 and 2012 were included as controls. After propensity score matching using age, sex, dialysis vintage, diabetes history, pneumonia history, and serum albumin and creatinine levels, survival analysis was performed. RESULTS The study included 89, 71, and 319 patients in the PPSV23, PCV13+PPSV23, and control groups, respectively. After propensity score matching, the PPSV23 and control group 1 (79 patients each) and the PCV13+PPSV23 and control group 2 (61 patients each) were compared. Significant differences were observed in the survival rate between the PPSV23 group and control group 1 (p = 0.005) but not between the PCV13+PPSV23 group and control group 2. Pneumonia-related mortality in the two vaccinated groups did not differ significantly during the observation period. CONCLUSIONS Patients who received PPSV23 had a favorable prognosis; however, no positive effect was demonstrated in the PCV13+PPSV23 group.
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Affiliation(s)
- Kosei Yamaguchi
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Nagasaki Renal Center, Nagasaki, Japan
| | - Mineaki Kitamura
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Nagasaki Renal Center, Nagasaki, Japan.
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | | | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomoya Nishino
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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25
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Yamaguchi O, Kasahara N, Soda H, Imai H, Naruse I, Yamaguchi H, Itai M, Taguchi K, Uchida M, Sunaga N, Maeno T, Minato K, Tomono H, Ogawara D, Mukae H, Miura Y, Shiono A, Mouri A, Kagamu H, Kaira K. Predictive significance of circulating tumor DNA against patients with T790M-positive EGFR-mutant NSCLC receiving osimertinib. Sci Rep 2023; 13:20848. [PMID: 38012343 PMCID: PMC10682450 DOI: 10.1038/s41598-023-48210-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 11/23/2023] [Indexed: 11/29/2023] Open
Abstract
Circulating tumor DNA (ctDNA) provides molecular information on tumor heterogeneity. The prognostic usefulness of ctDNA after first-line epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are limited. Therefore, the present study evaluated ctDNA during osimertinib administration as a second-line or more setting to identify the relationship between EGFR mutation levels and outcomes in patients with advanced non-small cell lung cancer (NSCLC). Forty patients with EGFR T790M-positive NSCLC receiving osimertinib after prior EGFR-TKI treatment were registered. Plasma samples were collected at osimertinib pretreatment, after 1 month of treatment, and at the time of progressive disease (PD). ctDNA analysis was performed by digital polymerase chain reaction. The detection rate of copy numbers of exon 19 deletion, L858R, and T790M in plasma samples was significantly lower 1 month after osimertinib than at pretreatment, and significantly higher at PD than at 1 month, whereas that of C797S was significantly higher at PD than at 1 month. No statistically significant difference was observed in the copy numbers of exon 19 deletion, L858R, T790M, and C797S between complete response or partial response and stable disease or PD. The detection of T790M at PD after osimertinib initiation was a significant independent prognostic factor for predicting shorter prognosis, and the presence of major EGFR mutations at pretreatment and PD was closely linked to worse survival after osimertinib initiation. Molecular testing based on ctDNA is helpful for predicting outcomes of osimertinib treatment in T790M-positive NSCLC after previous EGFR-TKI treatment.
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Affiliation(s)
- Ou Yamaguchi
- Department of Respiratory Medicine, International Medical Center, Comprehensive Cancer Center, Saitama Medical University, 1397-1 Yamane, Hidaka-City, Saitama, 350-1298, Japan
| | - Norimitsu Kasahara
- Innovative Medical Research Center, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma, 371-8511, Japan.
| | - Hiroshi Soda
- Department of Respiratory Medicine, Sasebo City General Hospital, Nagasaki, Japan
| | - Hisao Imai
- Department of Respiratory Medicine, International Medical Center, Comprehensive Cancer Center, Saitama Medical University, 1397-1 Yamane, Hidaka-City, Saitama, 350-1298, Japan
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan
| | - Ichiro Naruse
- Department of Respiratory Medicine, Hidaka Hospital, Kagoshima, Japan
| | - Hiroyuki Yamaguchi
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Miki Itai
- Department of Respiratory Medicine, Takasaki General Medical Center, Takasaki, Japan
| | - Kohei Taguchi
- Department of Respiratory Medicine, Takasaki General Medical Center, Takasaki, Japan
| | - Megumi Uchida
- Department of Respiratory Medicine, Takasaki General Medical Center, Takasaki, Japan
| | - Noriaki Sunaga
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Toshitaka Maeno
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Koichi Minato
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan
| | - Hiromi Tomono
- Department of Respiratory Medicine, Sasebo City General Hospital, Nagasaki, Japan
| | - Daiki Ogawara
- Department of Respiratory Medicine, Sasebo City General Hospital, Nagasaki, Japan
- Department of Respiratory Medicine, Fukuoka Wajiro Hospital, Fukuoka, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Yu Miura
- Department of Respiratory Medicine, International Medical Center, Comprehensive Cancer Center, Saitama Medical University, 1397-1 Yamane, Hidaka-City, Saitama, 350-1298, Japan
| | - Ayako Shiono
- Department of Respiratory Medicine, International Medical Center, Comprehensive Cancer Center, Saitama Medical University, 1397-1 Yamane, Hidaka-City, Saitama, 350-1298, Japan
| | - Atsuto Mouri
- Department of Respiratory Medicine, International Medical Center, Comprehensive Cancer Center, Saitama Medical University, 1397-1 Yamane, Hidaka-City, Saitama, 350-1298, Japan
| | - Hiroshi Kagamu
- Department of Respiratory Medicine, International Medical Center, Comprehensive Cancer Center, Saitama Medical University, 1397-1 Yamane, Hidaka-City, Saitama, 350-1298, Japan
| | - Kyoichi Kaira
- Department of Respiratory Medicine, International Medical Center, Comprehensive Cancer Center, Saitama Medical University, 1397-1 Yamane, Hidaka-City, Saitama, 350-1298, Japan.
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Ota K, Kodama H, Kawamoto Y, Sasaki D, Mitsumoto-Kaseida F, Sakamoto K, Kosai K, Hasegawa H, Takazono T, Izumikawa K, Mukae H, Tun MMN, Morita K, Yanagihara K. The evaluation of a rapid microfluidic immunofluorescence antigen test in detecting the infectiousness of COVID-19 patients. BMC Infect Dis 2023; 23:823. [PMID: 37996783 PMCID: PMC10668452 DOI: 10.1186/s12879-023-08821-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/14/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND A test-based strategy against coronavirus disease 2019 (COVID-19) is one of the measures to assess the need for isolation and prevention of infection. However, testing with high sensitivity methods, such as quantitative RT-PCR, leads to unnecessary isolation, whereas the lateral flow antigen test shows low sensitivity and false negative results. The purpose of this study was to evaluate the performance of the LumiraDx SARS-CoV-2 Ag test (Lumira Ag), a rapid microfluidic immunofluorescence method, in assessing infectivity. METHODS This study was performed from March 2022 to July 2022. A pair of nasopharyngeal swab samples were obtained from each patient with mild COVID-19. One swab was used for Lumira Ag testing, and the other for quantitative RT-PCR testing and virus culture. RESULTS A total of 84 patients were included in the study. Among them, PCR, Lumira Ag test, and virus culture indicated positivity for 82, 66, and 24 patients, respectively. When comparing the Lumira Ag test to virus culture, its sensitivity was 100.0% (24/24), specificity, 30.0% (18/60); positive predictive value, 36.3% (24/66); and negative predictive value (NPV), 100.0% (18/18). The positive sample for virus culture was observed until the ninth day from the onset of symptoms, while the Lumira Ag test was observed until day 11. CONCLUSIONS The Lumira Ag test showed high sensitivity and NPV (100% each) compared to virus culture. A test-based strategy using the Lumira Ag test can effectively exclude COVID-19 infectiousness.
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Affiliation(s)
- Kenji Ota
- Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan.
| | - Hina Kodama
- Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan
| | - Yasuhide Kawamoto
- Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan
| | - Daisuke Sasaki
- Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan
| | - Fujiko Mitsumoto-Kaseida
- Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan
| | - Kei Sakamoto
- Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan
- Department of Microbiology, Graduate School of Medicine, Yamaguchi University, 1-1-1, Minami-Kogushi, Ube, 755-8505, Japan
| | - Kosuke Kosai
- Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan
| | - Hiroo Hasegawa
- Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan
| | - Koichi Izumikawa
- Infection Control and Education Center, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan
| | - Mya Myat Ngwe Tun
- Department of Virology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4, Sakamoto, Nagasaki, 852-8102, Japan
| | - Kouichi Morita
- Department of Virology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4, Sakamoto, Nagasaki, 852-8102, Japan
- Dejima Infectious Disease Research Alliance, Nagasaki University, 1-12-4, Sakamoto, Nagasaki, 852-8102, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan
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27
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Tanaka Y, Kido T, Sakamoto N, Hara A, Kato T, Miyashita R, Ozasa M, Tokito T, Okuno D, Takeda K, Yura H, Takemoto S, Takazono T, Ishimoto H, Obase Y, Ishimatsu Y, Miyazaki Y, Mukae H. Lung Involvement in Adult T-Cell Lymphoma Diagnosed Using Bronchoscopic Cryobiopsy: A Case Report and Review of the Literature. Medicina (Kaunas) 2023; 59:2015. [PMID: 38004063 PMCID: PMC10673562 DOI: 10.3390/medicina59112015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/05/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023]
Abstract
The diagnosis of pulmonary lymphoma using small tissue samples is difficult and often requires surgical procedures; thus, a less invasive sampling method is desirable. Moreover, pulmonary involvement in adult T-cell lymphoma (ATL) is often difficult to diagnose, especially in cases without characteristic flower cells. Here, we present the case of a 78-year-old man, in whom pathological examination of the transbronchial lung biopsy (TBLB) specimen did not reveal malignant findings; therefore, transbronchial lung cryobiopsy (TBLC) in combination with endobronchial ultrasonography (EBUS) was used to diagnose ATL based on the pathological findings. A literature review identified 18 cases of pulmonary lymphomas diagnosed using TBLC. Among the 19 cases, including our own, 16 cases were of B-cell lymphoma (84.2%), and the present case is the first case of ATL diagnosed using TBLC. Eighty percent of the cases underwent a biopsy (more than two samples) of the middle or lower lobe and were diagnosed without major complications. EBUS was used with TBLC in three cases to identify the location of the pulmonary lesions. In the present case, EBUS was also useful for avoiding vascular biopsy. Although large-scale prospective studies are required to establish precise guidelines for diagnosing pulmonary lymphomas using TBLC, our case report and review contributes to a deeper understanding of the diagnosis of rare diseases.
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Affiliation(s)
- Yasuhiro Tanaka
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Takashi Kido
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Atsuko Hara
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Takeharu Kato
- Department of Hematology, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (T.K.)
| | - Ritsuko Miyashita
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Mutsumi Ozasa
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Takatomo Tokito
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Daisuke Okuno
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Kazuaki Takeda
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Hirokazu Yura
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Shinnosuke Takemoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8102, Japan
| | - Hiroshi Ishimoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Yasushi Obase
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Yuji Ishimatsu
- Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8102, Japan;
| | - Yasushi Miyazaki
- Department of Hematology, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (T.K.)
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
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28
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Matama G, Okamoto M, Fujimoto K, Johkoh T, Tominaga M, Mukae H, Sakamoto N, Komiya K, Umeki K, Komatsu M, Shimizu Y, Takahashi K, Tokisawa S, Zaizen Y, Matsuo N, Nouno T, Kaieda S, Ida H, Izuhara K, Hoshino T. Periostin Is a Biomarker of Rheumatoid Arthritis-Associated Interstitial Lung Disease. J Clin Med 2023; 12:7100. [PMID: 38002712 PMCID: PMC10672657 DOI: 10.3390/jcm12227100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/11/2023] [Accepted: 11/12/2023] [Indexed: 11/26/2023] Open
Abstract
Periostin was investigated as a biomarker for rheumatoid arthritis-associated interstitial lung disease (RA-ILD). This prospective study measured serum monomeric and total periostin, Klebs von den Lungen-6 (KL-6), surfactant protein D (SP-D), and lactate dehydrogenase (LDH) in 19 patients with RA-ILD, 20 RA without ILD, and 137 healthy controls (HC). All biomarkers were higher in RA-ILD than HC or RA without ILD. KL-6 accurately detected ILD in RA patients (area under curve [AUC] = 0.939) and moderately detected SP-D and monomeric and total periostin (AUC = 0.803, =0.767, =0.767, respectively). Monomeric and total periostin were negatively correlated with normal lung area and positively correlated with honeycombing, reticulation, fibrosis score, and the traction bronchiectasis grade but not inflammatory areas. Serum levels of SP-D, KL-6, and LDH did not correlate with the extent of those fibrotic areas on high-resolution CT. Serum monomeric and total periostin were higher in patients with RA-ILD with definite usual interstitial pneumonia pattern compared with other ILD patterns. Immunohistochemical analyses of biopsy or autopsy lung tissues from RA-ILD during the chronic phase and acute exacerbation showed that periostin was expressed in fibroblastic foci but not inflammatory or dense fibrosis lesions. Periostin is a potential biomarker for diagnosis, evaluating fibrosis, and deciding therapeutic strategies for patients with RA-ILD.
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Affiliation(s)
- Goushi Matama
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Ashahi-Machi 67, Kurume 830-0011, Japan; (G.M.)
| | - Masaki Okamoto
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Ashahi-Machi 67, Kurume 830-0011, Japan; (G.M.)
- Department of Respirology and Clinical Research Center, National Hospital Organization Kyushu Medical Center, Jigyohama 1-8-1, Chuou-ku, Fukuoka 810-0065, Japan
| | - Kiminori Fujimoto
- Department of Radiology, Kurume University School of Medicine, Ashahi-Machi 67, Kurume 830-0011, Japan
| | - Takeshi Johkoh
- Department of Radiology, Kansai Rosai Hospital, Inabasou 3-1-69, Amagasaki 660-0064, Japan
| | - Masaki Tominaga
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Ashahi-Machi 67, Kurume 830-0011, Japan; (G.M.)
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8501, Japan
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8501, Japan
| | - Kosaku Komiya
- Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, Idaigaoka 1-1, Hasama-Machi, Yufu 879-5593, Japan
| | - Kenji Umeki
- Department of Respiratory Medicine, Tenshindo Hetsugi Hospital, Nihongi 5956, Nakahetsugi 879-7761, Japan
| | - Masamichi Komatsu
- First Department of Internal Medicine, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto 390-8621, Japan
| | - Yasuo Shimizu
- Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University School of Medicine, Kitakobayashi 880, Mibu 321-0293, Japan
| | - Koichiro Takahashi
- Department of Respirology, Saga Medical School, Nabeshima 5-1-1, Saga 849-8501, Japan
| | - Saeko Tokisawa
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Ashahi-Machi 67, Kurume 830-0011, Japan; (G.M.)
| | - Yoshiaki Zaizen
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Ashahi-Machi 67, Kurume 830-0011, Japan; (G.M.)
| | - Norikazu Matsuo
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Ashahi-Machi 67, Kurume 830-0011, Japan; (G.M.)
- Department of Respirology and Clinical Research Center, National Hospital Organization Kyushu Medical Center, Jigyohama 1-8-1, Chuou-ku, Fukuoka 810-0065, Japan
| | - Takashi Nouno
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Ashahi-Machi 67, Kurume 830-0011, Japan; (G.M.)
- Department of Respirology and Clinical Research Center, National Hospital Organization Kyushu Medical Center, Jigyohama 1-8-1, Chuou-ku, Fukuoka 810-0065, Japan
| | - Shinjiro Kaieda
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Ashahi-Machi 67, Kurume 830-0011, Japan; (G.M.)
| | - Hiroaki Ida
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Ashahi-Machi 67, Kurume 830-0011, Japan; (G.M.)
| | - Kenji Izuhara
- Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, Nabeshima 5-1-1, Saga 849-8501, Japan
| | - Tomoaki Hoshino
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Ashahi-Machi 67, Kurume 830-0011, Japan; (G.M.)
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29
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Tsukamoto Y, Ito Y, Obase Y, Takazono T, Nakada N, Ashizawa N, Hirayama T, Takeda K, Ide S, Iwanaga N, Tashiro M, Hosogaya N, Fukahori S, Fukushima C, Yanagihara K, Izumikawa K, Mukae H. Serum Cytokine Changes in a Patient with Chronic Pulmonary Aspergillosis Overlapping with Allergic Bronchopulmonary Aspergillosis: A Case Report. Intern Med 2023:2234-23. [PMID: 37899245 DOI: 10.2169/internalmedicine.2234-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2023] Open
Abstract
Allergic bronchopulmonary aspergillosis (ABPA) and chronic pulmonary aspergillosis (CPA) are diseases caused by Aspergillus infection, and CPA can develop from ABPA in some cases. We herein report a patient with CPA overlapping with ABPA. Serum cytokine levels were evaluated at 4 time points: the ABPA diagnosis, CPA diagnosis, 6 months after the start of voriconazole (VRCZ), and 12 months after re-administration of VRCZ. Interleukin (IL)-13 levels decreased upon glucocorticoid treatment, whereas IL-25 and IL-33 levels decreased rapidly with the initiation of antifungals. Early antifungal therapy may be important to control disease progression and prevent CPA overlap.
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Affiliation(s)
- Yusei Tsukamoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
| | - Yuya Ito
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
| | - Yasushi Obase
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Nana Nakada
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
| | - Nobuyuki Ashizawa
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
- Infection Control and Education Center, Nagasaki University Hospital, Japan
| | - Tatsuro Hirayama
- Department of Pharmacotherapeutics, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Kazuaki Takeda
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
| | - Shotaro Ide
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
- Infectious Diseases Experts Training Center, Nagasaki University Hospital, Japan
| | - Naoki Iwanaga
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
| | - Masato Tashiro
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Japan
- Infection Control and Education Center, Nagasaki University Hospital, Japan
| | - Naoki Hosogaya
- Clinical Research Center, Nagasaki University Hosipital, Japan
| | - Susumu Fukahori
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
| | - Chizu Fukushima
- Clinical Research Center, Nagasaki University Hosipital, Japan
| | | | - Koichi Izumikawa
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Japan
- Infection Control and Education Center, Nagasaki University Hospital, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
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Miyazaki T, Fukushima K, Hashiguchi K, Ide S, Kobayashi T, Sawai T, Yatera K, Kohno Y, Fukuda Y, Futsuki Y, Matsubara Y, Koga H, Mihara T, Sasaki E, Ashizawa N, Hirayama T, Takazono T, Yamamoto K, Imamura Y, Kaku N, Kosai K, Morinaga Y, Yanagihara K, Mukae H. A high α1-antitrypsin/interleukin-10 ratio predicts bacterial pneumonia in adults with community-acquired pneumonia: a prospective cohort study. Pneumonia (Nathan) 2023; 15:16. [PMID: 37876022 PMCID: PMC10599029 DOI: 10.1186/s41479-023-00118-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/10/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Current microbiological tests fail to identify the causative microorganism in more than half of all pneumonia cases. We explored biomarkers that could be used for differentiating between bacterial and viral pneumonia in patients with community-acquired pneumonia (CAP). METHODS In this prospective cohort study conducted in Japan, data obtained from adult patients with bacterial pneumonia, including bacterial and viral coinfections (bacterial pneumonia [BP] group), and purely viral pneumonia (VP group) at diagnosis were analyzed using multivariate logistic regression analysis to identify predictors of bacterial pneumonia. Furthermore, a decision tree was developed using the predictors. RESULTS A total of 210 patients were analyzed. The BP and VP groups comprised 108 and 18 patients, respectively. The other 84 patients had no identified causative microorganism. The two groups shared similar characteristics, including disease severity; however, a significant difference (p < 0.05) was observed between the two groups regarding sputum type; sputum volume score; neutrophil counts; and serum levels of interleukin (IL)-8, IL-10, and α1-antitrypsin (AAT). Sputum volume score (p < 0.001), IL-10 (p < 0.001), and AAT (p = 0.008) were ultimately identified as predictors of BP. The area under the curve for these three variables on the receiver operating characteristic (ROC) curve was 0.927 (95% confidence interval [CI]: 0.881-0.974). The ROC curve for sputum volume score and an AAT/IL-10 ratio showed a diagnostic cutoff of 1 + and 65, respectively. Logistic regression analysis using dichotomized variables at the cutoff values showed that the odds ratios for the diagnosis of BP were 10.4 (95% CI: 2.2-50.2) for sputum volume score (absence vs. presence) and 19.8 (95% CI: 4.7-83.2) for AAT/IL-10 ratio (< 65 vs. ≥ 65). CONCLUSIONS Considering that obtaining a definitive etiologic diagnosis with the current testing methods is difficult and time consuming, a decision tree with two predictors, namely sputum volume and the AAT/IL-10 ratio, can be useful in predicting BP among patients diagnosed with CAP and facilitating the appropriate use of antibiotics. TRIAL REGISTRATION UMIN000034673 registered on November 29, 2018.
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Affiliation(s)
- Taiga Miyazaki
- Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.
| | | | | | - Shotaro Ide
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
- Isahaya General Hospital, Isahaya, Japan
| | | | | | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | | | | | | | | | | | | | | | - Nobuyuki Ashizawa
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Tatsuro Hirayama
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
- Department of Pharmacotherapeutics, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Kazuko Yamamoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
- First Department of Internal Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Okinawa, Japan
| | - Yoshifumi Imamura
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
- Medical Education Development Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Norihito Kaku
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kosuke Kosai
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yoshitomo Morinaga
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Microbiology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
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31
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Otsuka E, Kitamura M, Sawase K, Nakamura M, Inoue H, Yamaguchi K, Funakoshi S, Takazono T, Mukae H, Nishino T. Hereditary Hemorrhagic Telangiectasia in a Patient Undergoing Hemodialysis with Anticoagulants and Antiplatelets: A Case Report. Intern Med 2023:2180-23. [PMID: 37866921 DOI: 10.2169/internalmedicine.2180-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2023] Open
Abstract
Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder that causes abnormal blood vessel formation and bleeding. We herein report a 61-year-old woman with aggravated HHT symptoms after hemodialysis initiation. She was diagnosed with HHT based on her recurrent bleeding, abnormal blood vessel formation, and family history. Despite bleeding complications, the patient required anticoagulants and antiplatelet agents to treat cardiovascular complications. Eventually, the patient died of extensive cerebral hemorrhaging. Our experience suggests that special attention should be paid to bleeding complications in high-risk patients.
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Affiliation(s)
- Emiko Otsuka
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Japan
- Nagasaki Renal Center, Japan
| | - Mineaki Kitamura
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Japan
- Nagasaki Renal Center, Japan
| | | | - Maiko Nakamura
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Japan
- Nagasaki Renal Center, Japan
| | - Hiro Inoue
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Kosei Yamaguchi
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | | | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Tomoya Nishino
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Japan
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Mine K, Sakamoto N, Ozasa M, Tsutsui S, Miyashita R, Tokito T, Okuno D, Yura H, Kido T, Ishimoto H, Takemoto S, Takazono T, Obase Y, Ishimatsu Y, Fukuoka J, Mukae H. Pulmonary Langerhans cell histiocytosis diagnosed using transbronchial lung cryobiopsy: A case report. Respir Med Case Rep 2023; 46:101928. [PMID: 37869608 PMCID: PMC10585380 DOI: 10.1016/j.rmcr.2023.101928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/12/2023] [Accepted: 10/07/2023] [Indexed: 10/24/2023] Open
Abstract
A 63-year-old Japanese woman with multiple cysts in both lungs on chest computed tomography (CT) was referred to our hospital after a thorough examination, including a transbronchial lung biopsy (TBLB), failed to provide a diagnosis. Based on the findings on chest CT and pathological examination of the bronchoalveolar lavage fluid and transbronchial lung cryobiopsy (TBLC) specimen, the patient was diagnosed with pulmonary Langerhans cell histiocytosis (PLCH). TBLC may replace TBLB as the main diagnostic technique for PLCH, although further studies are required to determine the usefulness of TBLC for the diagnosis of PLCH.
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Affiliation(s)
- Keisuke Mine
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Mutsumi Ozasa
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Shin Tsutsui
- Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Ritsuko Miyashita
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Takatomo Tokito
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Daisuke Okuno
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Hirokazu Yura
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Takashi Kido
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Hiroshi Ishimoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Shinnosuke Takemoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Yasushi Obase
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Yuji Ishimatsu
- Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8520, Japan
| | - Junya Fukuoka
- Department of Pathology Informatics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8523, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
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Ashizawa N, Takazono T, Ito Y, Nakada N, Hirayama T, Takeda K, Ide S, Iwanaga N, Tashiro M, Hosogaya N, Yanagihara K, Mukae H, Izumikawa K. Antifungal susceptibility profiles of Cryptococcus neoformans strains clinically isolated from non-HIV-infected patients in Nagasaki, Japan. Med Mycol 2023; 61:myad100. [PMID: 37740432 DOI: 10.1093/mmy/myad100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/04/2023] [Accepted: 09/20/2023] [Indexed: 09/24/2023] Open
Abstract
Data on antifungal susceptibility of Cryptococcus neoformans are limited in Japan. A total of 89 C. neoformans strains isolated from 83 non-human immunodeficiency virus-infected patients with cryptococcosis between 1997 and 2021 in Nagasaki, Japan, were investigated. Using the reference method M27-Ed4 by the Clinical and Laboratory Standards Institute, the minimum inhibitory concentration for 90% of isolates of fluconazole, itraconazole, voriconazole, amphotericin B, and flucytosine were 4, 0.125, 0.06, 0.5, and 4 µg/ml, respectively, which were below the reported epidemiological cutoff values, without any detectable non-wild-type strains. Our findings imply no increasing trend of antifungal-resistant C. neoformans in Nagasaki, Japan.
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Affiliation(s)
- Nobuyuki Ashizawa
- Infection Control and Education Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852- 8501, Japan
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Yuya Ito
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Nana Nakada
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
- Health Center, Nagasaki University, 1-14 Bunkyo, Nagasaki 852-8521, Japan
| | - Tatsuro Hirayama
- Department of Pharmacotherapeutics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Kazuaki Takeda
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Shotaro Ide
- Infectious Diseases Experts Training Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Naoki Iwanaga
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Masato Tashiro
- Infection Control and Education Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852- 8501, Japan
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Naoki Hosogaya
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
- Clinical Research Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Koichi Izumikawa
- Infection Control and Education Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852- 8501, Japan
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
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Tashiro M, Namie H, Ito Y, Takazono T, Kakeya H, Miyazaki Y, Mukae H, Mikamo H, Tomoo F, Shibuya K, Izumikawa K. Prognostic Association of Liposomal Amphotericin B Doses Above 5 mg/kg/d in Mucormycosis: A Nationwide Epidemiologic and Treatment Analysis in Japan. Open Forum Infect Dis 2023; 10:ofad480. [PMID: 37808895 PMCID: PMC10552064 DOI: 10.1093/ofid/ofad480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/19/2023] [Indexed: 10/10/2023] Open
Abstract
Background Mucormycosis is a potentially fatal fungal infection, and there is limited information on its precise epidemiology and treatment practices, including the optimal dosage of liposomal amphotericin B. Methods A retrospective, multicenter, nationwide analysis of 82 proven and probable cases of mucormycosis was performed. Cases between 2015 and 2022 were collected from 51 hospitals in Japan by hematologists and infectious disease specialists. The study included the epidemiology, treatment details, and association between the dose of liposomal amphotericin B and the outcome. Results The lungs were the most commonly involved organ (70.7% of cases), and 35.4% of patients had disseminated disease. Rhizopus spp., Cunninghamella spp., and Mucor spp. were the most common organisms. Mortality at 4 weeks was 41.5%. The survivors had a shorter duration of neutropenia (P = .006) and less persistent hyperglycemia (P = .023). The site of infection and species of Mucorales had no detectable effect on survival. Survival did not differ between patients receiving liposomal amphotericin B at 5 mg/kg/d relative to those receiving >5 mg/kg/d (P = .625). Using Cox proportional hazards models and adjusting for confounders, the hazard ratio for the influence of >5 mg/kg/d liposomal amphotericin B on 4-week survival was 0.86 (95% CI, 0.28-2.68; P = .796) compared with 5 mg/kg/d. Conclusions This study provides important insights into the precise epidemiology and treatment practices of mucormycosis. Treatment with liposomal amphotericin B at doses higher than 5 mg/kg/d did not improve outcomes relative to 5 mg/kg/d.
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Affiliation(s)
- Masato Tashiro
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Hotaka Namie
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yuya Ito
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Takahiro Takazono
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Hiroshi Kakeya
- Department of Infection Control Science, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yoshitsugu Miyazaki
- Department of Fungal Infection, National Institute of Infectious Disease, Tokyo, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan
| | - Fukuda Tomoo
- Department of Dermatology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Kazutoshi Shibuya
- Department of Pathology, Toho University Omori Medical Center, Tokyo, Japan
| | - Koichi Izumikawa
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki, Japan
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Yamaguchi K, Kitamura M, Otsuka E, Notomi S, Funakoshi S, Mukae H, Nishino T. Association between annual variability of potassium levels and prognosis in patients undergoing hemodialysis. Clin Exp Nephrol 2023; 27:873-881. [PMID: 37318722 DOI: 10.1007/s10157-023-02368-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/05/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Hyperkalemia and hypokalemia are associated with mortality in patients undergoing hemodialysis. However, there are few reports on the association between potassium level fluctuations and mortality. We retrospectively investigated the association between serum potassium level variability and mortality in patients undergoing hemodialysis. METHODS This study was conducted at a single center. Variability in serum potassium levels was evaluated using the standard deviation of potassium level from July 2011 to June 2012, and its association with prognosis was examined by following up the patients for 5 years. Serum potassium variability was assessed as the coefficient of variation, and the statistical analysis was performed after log transformation. RESULTS Among 302 patients (mean age 64.9 ± 13.3; 57.9% male; and median dialysis vintage 70.5 months [interquartile range, IQR 34-138.3]), 135 died during the observation period (median observation period 5.0 years [2.3-5.0]). Although the mean potassium level was not associated with prognosis, serum potassium level variability was associated with prognosis, even after adjustments for confounding factors such as age and dialysis time (hazard ratio: 6.93, 95% confidence interval [Cl] 1.98-25.00, p = 0.001). After the adjustments, the coefficient of variation of potassium level in the highest tertile (T3) showed a higher relative risk for prognosis than that in T1 (relative risk: 1.98, 95% CI 1.19-3.29, p = 0.01). CONCLUSIONS Variability in serum potassium levels was associated with mortality in patients undergoing hemodialysis. Careful monitoring of potassium levels and their fluctuations is necessary for this patient population.
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Affiliation(s)
- Kosei Yamaguchi
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Nagasaki Renal Center, Nagasaki, Japan
| | - Mineaki Kitamura
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
- Nagasaki Renal Center, Nagasaki, Japan.
| | | | | | | | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomoya Nishino
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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36
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Torigoe K, Yoshida Y, Sakamoto R, Abe S, Muta K, Arai H, Mukae H, Nishino T. Improvement in Tubulointerstitial Nephritis With Glucocorticoid Therapy in an Anorexia Nervosa Patient. J Med Cases 2023; 14:344-349. [PMID: 37868329 PMCID: PMC10586332 DOI: 10.14740/jmc4152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023] Open
Abstract
Anorexia nervosa is a psychiatric disorder that is often diagnosed in adolescents and young adults. Renal-related complications of anorexia nervosa include abnormal water metabolism, electrolyte abnormalities, and nephrocalcinosis, which may lead to irreversible renal damage. Furthermore, tubulointerstitial nephritis has been reported as a renal pathological feature of anorexia nervosa. Immunosuppressive therapy, such as with glucocorticoids, has been recommended for idiopathic interstitial nephritis treatment; however, the effectiveness of immunosuppressive therapy for interstitial nephritis in patients with anorexia nervosa remains unestablished. Here, we report a case of interstitial nephritis in a patient with anorexia nervosa whose renal function was successfully improved with glucocorticoid therapy. The patient was a 38-year-old woman who was referred for renal dysfunction (estimated glomerular filtration rate: 7.6 mL/min/1.73 m2). She had anorexia nervosa and repeated episodes of vomiting. Hypokalemia (K: 2.1 mEq/L) and metabolic alkalosis (HCO3-: 54.2 mEq/L) were observed. Fluid therapy and potassium supplementation did not improve renal function; therefore, a percutaneous renal biopsy was performed. The renal pathology results revealed interstitial fibrosis, inflammatory cell infiltration in the interstitium, and tubulitis, suggesting a diagnosis of tubulointerstitial nephritis. Glucocorticoid therapy improved the patient's renal function to an estimated glomerular filtration rate of 19.91 mL/min/1.73 m2, and the renal function remained stable thereafter. This case suggests that glucocorticoid therapy may be considered for the treatment of interstitial nephritis in patients with anorexia.
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Affiliation(s)
- Kenta Torigoe
- Department of Nephrology, Nagasaki University Hospital, Nagasaki City, Nagasaki 852-8501, Japan
| | - Yuki Yoshida
- Department of Nephrology, Nagasaki University Hospital, Nagasaki City, Nagasaki 852-8501, Japan
| | - Ryosuke Sakamoto
- Department of Nephrology, Nagasaki University Hospital, Nagasaki City, Nagasaki 852-8501, Japan
| | - Shinichi Abe
- Department of Nephrology, Nagasaki University Hospital, Nagasaki City, Nagasaki 852-8501, Japan
| | - Kumiko Muta
- Department of Nephrology, Nagasaki University Hospital, Nagasaki City, Nagasaki 852-8501, Japan
| | - Hideyuki Arai
- Kusumoto Naika Clinic, Omura City, Nagasaki 856-0817, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki City, Nagasaki 852-8501, Japan
| | - Tomoya Nishino
- Department of Nephrology, Nagasaki University Hospital, Nagasaki City, Nagasaki 852-8501, Japan
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Tomono H, Taniguchi H, Fukuda M, Ikeda T, Nagashima S, Akagi K, Ono S, Umeyama Y, Shimada M, Gyotoku H, Takemoto S, Hisamatsu Y, Morinaga R, Tagawa R, Ogata R, Dotsu Y, Senju H, Soda H, Nakatomi K, Hayashi F, Sugasaki N, Kinoshita A, Mukae H. Phase II study of IRInotecan treatment after COmbined chemo-immunotherapy for extensive-stage small cell lung cancer: Protocol of IRICO study. Thorac Cancer 2023; 14:2890-2894. [PMID: 37675546 PMCID: PMC10542459 DOI: 10.1111/1759-7714.15097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/08/2023] Open
Abstract
INTRODUCTION Combined treatment using anti-programmed death-ligand 1 antibody (anti-PD-L1) and platinum-etoposide is the current standard first-line treatment for patients with extensive-stage (ES) small cell lung cancer (SCLC). However, the best treatment for relapsed ES-SCLC after the first-line treatment remains unclear. There are some approved chemotherapeutic agents that can be used against ES-SCLC, and treatment with irinotecan is well established as both a monotherapy and a combined therapy, in combination with platinum. Therefore, we conduct a phase II study with irinotecan in the second- or later-line setting for patients with ES-SCLC who have been previously treated with combined treatment. METHODS Our study will enroll total 30 patients who are diagnosed with ES-SCLC and have experienced disease progression after the combined treatment. Patients will receive irinotecan on days 1, 8, and 15, which will be repeated every 4 weeks. Doses of irinotecan (100/80/60 mg/m2 ) will be determined according to the type of UGT1A1 gene polymorphism, and the treatment will be discontinued following disease progression, intolerance, withdrawal of patient consent, and based on the investigator's decision. The primary endpoint of the study is the response rate, and the secondary endpoints are overall survival, progression-free survival, and safety. DISCUSSION Since the present first-line treatment has been changed to the combined treatment, the second- or later-line treatment should be re-evaluated for patients with relapsed SCLC. Irinotecan is a major chemotherapeutic agent used for SCLC. This study demonstrates and re-evaluates the clinical benefits of irinotecan after combined treatment with anti-PD-L1 and platinum-etoposide for patients with ES-SCLC. REGISTRATION DETAILS This study was registered in the Japan Registry of Clinical Trials (no. jRCT s071210090) on November 4, 2021.
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Affiliation(s)
- Hiromi Tomono
- Department of Respiratory MedicineNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
- Department of Respiratory MedicineNational Hospital Organization Nagasaki Medical CenterNagasakiJapan
| | - Hirokazu Taniguchi
- Department of Respiratory MedicineNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
- Clinical Oncology CenterNagasaki University HospitalNagasakiJapan
| | - Minoru Fukuda
- Clinical Oncology CenterNagasaki University HospitalNagasakiJapan
- Department of Respiratory MedicineNagasaki Prefecture Shimabara HospitalNagasakiJapan
| | - Takaya Ikeda
- Department of Respiratory MedicineNational Hospital Organization Nagasaki Medical CenterNagasakiJapan
| | - Seiji Nagashima
- Department of Respiratory MedicineNational Hospital Organization Nagasaki Medical CenterNagasakiJapan
| | - Kazumasa Akagi
- Department of Respiratory MedicineNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
| | - Sawana Ono
- Department of Respiratory MedicineNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
| | - Yasuhiro Umeyama
- Department of Respiratory MedicineNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
| | - Midori Shimada
- Department of Respiratory MedicineNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
- Clinical Research CenterNagasaki University HospitalNagasakiJapan
| | - Hiroshi Gyotoku
- Department of Respiratory MedicineNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
| | - Shinnosuke Takemoto
- Department of Respiratory MedicineNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
| | - Yasushi Hisamatsu
- Department of Thoracic Medical OncologyOita Prefectural HospitalOitaJapan
| | - Ryotaro Morinaga
- Department of Thoracic Medical OncologyOita Prefectural HospitalOitaJapan
| | - Ryuta Tagawa
- Department of Respiratory MedicineSasebo City General HospitalNagasakiJapan
| | - Ryosuke Ogata
- Department of Respiratory MedicineNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
- Department of Respiratory MedicineSasebo City General HospitalNagasakiJapan
| | - Yosuke Dotsu
- Department of Respiratory MedicineSasebo City General HospitalNagasakiJapan
| | - Hiroaki Senju
- Department of Respiratory MedicineSasebo City General HospitalNagasakiJapan
- Department of Internal MedicineSenju HospitalNagasakiJapan
| | - Hiroshi Soda
- Department of Respiratory MedicineSasebo City General HospitalNagasakiJapan
| | - Katsumi Nakatomi
- Department of Respiratory MedicineNational Hospital Organization Ureshino Medical CenterSagaJapan
| | - Fumiko Hayashi
- Department of Respiratory MedicineNagasaki Prefecture Shimabara HospitalNagasakiJapan
| | - Nanae Sugasaki
- Department of Respiratory MedicineNagasaki Prefecture Shimabara HospitalNagasakiJapan
| | - Akitoshi Kinoshita
- Department of Respiratory MedicineNagasaki Prefecture Shimabara HospitalNagasakiJapan
| | - Hiroshi Mukae
- Department of Respiratory MedicineNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
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Ashizawa H, Iwanaga N, Kurohama H, Ito Y, Ashizawa N, Hirayama T, Takeda K, Ide S, Nagayoshi Y, Tashiro M, Takazono T, Tagawa T, Fukushima K, Ito M, Nakamura S, Izumikawa K, Yanagihara K, Miyazaki Y, Mukae H. Pulmonary Coccidioidomycosis Complicated by Nontuberculous Mycobacterial Pulmonary Diseases with a Literature Review. Jpn J Infect Dis 2023; 76:314-318. [PMID: 37258176 DOI: 10.7883/yoken.jjid.2023.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Following an endobronchial examination, a young mine supervisor was treated with antibiotics for a pulmonary nontuberculous mycobacterial infection for approximately one year. However, a review of the radiological findings revealed a different possibility. Accordingly, pulmonary resection was performed, and histopathological analysis revealed numerous yeast-like fungi. Since the patient had stayed in the southwestern United States for two months in 2009, eight years previously, coccidioidomycosis was strongly suspected. The diagnosis of coccidioidomycosis was subsequently confirmed by serology and polymerase chain reaction testing of the excised specimen. Here, we report an educational case that emphasizes the importance of meticulous medical history-taking and awareness of endemic mycoses in other countries in the context of globalization.
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Affiliation(s)
- Hiroki Ashizawa
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
- Department of Respiratory Medicine, Nagasaki Medical Center, Japan
| | - Naoki Iwanaga
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
- Department of Respiratory Medicine, Nagasaki Medical Center, Japan
| | - Hirokazu Kurohama
- Department of Pathology, Nagasaki University Hospital, Japan
- Department of Pathology, National Hospital Organization, Nagasaki Medical Center, Japan
| | - Yuya Ito
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
| | - Nobuyuki Ashizawa
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
- Department of Infection Control and Education Center, Nagasaki University Hospital, Japan
| | - Tatsuro Hirayama
- Department of Pharmacotherapeutics, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Kazuaki Takeda
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
| | - Shotaro Ide
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
- Infectious Diseases Experts Training Center, Nagasaki University Hospital, Japan
| | - Yohsuke Nagayoshi
- Department of Respiratory Medicine, Nagasaki Medical Center, Japan
- Division of Respiratory Medicine, Japanese Red Cross Nagasaki Genbaku Isahaya Hospital, Japan
| | - Masato Tashiro
- Department of Infection Control and Education Center, Nagasaki University Hospital, Japan
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Tsutomu Tagawa
- Department of Thoracic Surgery, National Hospital Organization, Nagasaki Medical Center, Japan
| | - Kiyoyasu Fukushima
- Division of Respiratory Medicine, Japanese Red Cross Nagasaki Genbaku Isahaya Hospital, Japan
| | - Masahiro Ito
- Department of Pathology, National Hospital Organization, Nagasaki Medical Center, Japan
| | - Shigeki Nakamura
- Department of Microbiology, Tokyo Medical University, Japan
- Department of Fungal Infection, National Institute of Infectious Diseases, Japan
| | - Koichi Izumikawa
- Department of Infection Control and Education Center, Nagasaki University Hospital, Japan
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | | | - Yoshitsugu Miyazaki
- Department of Fungal Infection, National Institute of Infectious Diseases, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Japan
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Nakada N, Miyazaki T, Mizuta S, Hirayama T, Nakamichi S, Takeda K, Mukae H, Kohno S, Tanaka Y. Screening and Synthesis of Tetrazole Derivatives that Inhibit the Growth of Cryptococcus Species. ChemMedChem 2023; 18:e202300157. [PMID: 37427766 DOI: 10.1002/cmdc.202300157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/06/2023] [Accepted: 07/06/2023] [Indexed: 07/11/2023]
Abstract
Cryptococcosis has become a major health problem worldwide and caused morbidity and mortality in immunocompromised patients, especially those infected with human immunodeficiency virus (HIV). Despite the global distribution of cryptococcosis, the number and types of the available antifungals are limited, and the treatment outcomes in HIV patients are generally poor. In this study, we screened a compound library and identified one tetrazole derivative as an efficient inhibitor of Cryptococcus neoformans and Cryptococcus gattii. We further designed and synthesized a series of tetrazole derivatives and determined their structure-activity relationship, demonstrating that tetrazole backbone-containing compounds could be developed as novel antifungal drugs with distinct mechanisms against Cryptococcus spp. Our findings provide a starting point for novel target identification and structural optimization to develop a distinct class of therapeutics for patients with cryptococcosis.
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Affiliation(s)
- Nana Nakada
- Health Center, Nagasaki University, 1-14 Bunkyo-machi, Nagasaki, 852-8521, Japan
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8523, Japan
| | - Taiga Miyazaki
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8523, Japan
- Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Satoshi Mizuta
- Center for Bioinformatics and Molecular Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, Japan
| | - Tatsuro Hirayama
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8523, Japan
- Department of Pharmacotherapeutics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Seiko Nakamichi
- Health Center, Nagasaki University, 1-14 Bunkyo-machi, Nagasaki, 852-8521, Japan
| | - Kohsuke Takeda
- Department of Cell Regulation, Nagasaki University Graduate School of Biomedical Sciences, 1-14 Bunkyo-machi, Nagasaki, 852-8521, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8523, Japan
| | - Shigeru Kohno
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8523, Japan
| | - Yoshimasa Tanaka
- Center for Medical Innovation, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Japan
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Fujikura Y, Somekawa K, Manabe T, Horita N, Takahashi H, Higa F, Yatera K, Miyashita N, Imamura Y, Iwanaga N, Mukae H, Kawana A. Aetiological agents of adult community-acquired pneumonia in Japan: systematic review and meta-analysis of published data. BMJ Open Respir Res 2023; 10:e001800. [PMID: 37751988 PMCID: PMC10533802 DOI: 10.1136/bmjresp-2023-001800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 09/08/2023] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVE Epidemiological information is essential in providing appropriate empiric antimicrobial therapy for pneumonia. This study aimed to clarify the epidemiology of community-acquired pneumonia (CAP) by conducting a systematic review of published studies in Japan. DESIGN Systematic review. DATA SOURCE PubMed and Ichushi web database (January 1970 to October 2022). ELIGIBILITY CRITERIA Clinical studies describing pathogenic micro-organisms in CAP written in English or Japanese, excluding studies on pneumonia other than adult CAP, investigations limited to specific pathogens and case reports. DATA EXTRACTION AND SYNTHESIS Patient setting (inpatient vs outpatient), number of patients, concordance with the CAP guidelines, diagnostic criteria and methods for diagnosing pneumonia pathogens as well as the numbers of each isolate. A meta-analysis of various situations was performed to measure the frequency of each aetiological agent. RESULTS Fifty-six studies were included and 17 095 cases of CAP were identified. Pathogens were undetectable in 44.1% (95% CI 39.7% to 48.5%). Streptococcus pneumoniae was the most common cause of CAP requiring hospitalisation or outpatient care (20.0% (95% CI 17.2% to 22.8%)), followed by Haemophilus influenzae (10.8% (95% CI 7.3% to 14.3%)) and Mycoplasma pneumoniae (7.5% (95% CI 4.6% to 10.4%)). However, when limited to CAP requiring hospitalisation, Staphylococcus aureus was the third most common at 4.9% (95% CI 3.9% to 5.8%). Pseudomonas aeruginosa was more frequent in hospitalised cases, while atypical pathogens were less common. Methicillin-resistant S. aureus accounted for 40.7% (95% CI 29.0% to 52.4%) of S. aureus cases. In studies that used PCR testing for pan-respiratory viral pathogens, human enterovirus/human rhinovirus (9.4% (95% CI 0% to 20.5%)) and several other respiratory pathogenic viruses were detected. The epidemiology varied depending on the methodology and situation. CONCLUSION The epidemiology of CAP varies depending on the situation, such as in the hospital versus outpatient setting. Viruses are more frequently detected by exhaustive genetic searches, resulting in a significant variation in epidemiology.
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Affiliation(s)
- Yuji Fujikura
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
- Department of Medical Risk Management and Infection Control, National Defense Medical College Hospital, Tokorozawa, Saitama, Japan
| | - Kohei Somekawa
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Toshie Manabe
- Graduate School of Medical Science, Nagoya City University, Nagoya, Aichi, Japan
- West Medical Center, Nagoya City University, Nagoya, Aichi, Japan
| | - Nobuyuki Horita
- Chemotherapy Center, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | - Hiroshi Takahashi
- Department of Respiratory Medicine, Saka General Hospital, Shiogama, Miyagi, Japan
| | - Futoshi Higa
- Division of Respiratory Medicine, National Hospital Organization Okinawa National Hospital, Ginowan, Okinawa, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Fukuoka, Japan
| | - Naoyuki Miyashita
- First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, Hirakata, Osaka, Japan
| | - Yoshifumi Imamura
- Medical Education Development Center, Nagasaki University Hospital, Nagasaki, Nagasaki, Japan
| | - Naoki Iwanaga
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Nagasaki, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Nagasaki, Japan
| | - Akihiko Kawana
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
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Chojin Y, Okamoto N, Noguchi S, Fube Y, Aritake Y, Shiraki M, Izumitani K, Suzuki M, Omori M, Kato T, Mukae H, Yatera K. Clinical efficacy of assessment of swallowing ability for pneumonia and other assessment tools for occurrence and mortality from pneumonia among older inpatients in a long-term care hospital. Respir Investig 2023; 61:651-659. [PMID: 37531712 DOI: 10.1016/j.resinv.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 06/20/2023] [Accepted: 06/29/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Aspiration pneumonia is an important condition in elderly patients and detecting dysphagia early can help clinicians identify patients with a high risk of aspiration pneumonia. We previously reported the usefulness of the Assessment of Swallowing Ability for Pneumonia (ASAP) in predicting the occurrence of and mortality from pneumonia in patients in acute care hospitals; however, there are very few reports on the utility of this screening test for patients in stable condition. METHODS Elderly patients in stable condition (n = 133) without pneumonia were prospectively enrolled. Associations between ASAP, Functional Independence Measure (FIM), Controlling Nutrition Status (CONUT), and Charlson Co-morbidity Index (CCI) scores and occurrence of/mortality from pneumonia during hospitalization were evaluated. RESULTS The occurrence of pneumonia was observed in 27 (20.3%) patients, and 18 (13.5%) died during hospitalization. Multivariate analysis showed that low ASAP score and low FIM motor were independent predictors for the occurrence of pneumonia, and low ASAP score was an independent predictor for mortality from pneumonia. Areas under the curve for ASAP, FIM motor, FIM cognition, and CONUT scores were 0.895 (95% confidence interval [CI], 0.829-0.960), 0.913 (95% CI, 0.860-0.968), 0.841 (95% CI, 0.761-0.921), and 0.753 (95% CI, 0.649-0.858), respectively, for occurrence, and 0.881 (95% CI, 0.807-0.955), 0.904 (95% CI, 0.860-0.949), 0.829 (95% CI, 0.727-0.931), 0.746 (95% CI, 0.617-0.874), respectively, for mortality. CONCLUSION The ASAP and FIM motor are useful for predicting the occurrence of and mortality from pneumonia in elderly inpatients in long-term care hospitals.
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Affiliation(s)
- Yasuo Chojin
- Department of Respiratory Medicine, Kitakyushu Central Hospital, Japan.
| | - Naoki Okamoto
- Department of Respiratory Medicine, Kitakyushu Central Hospital, Japan
| | - Shingo Noguchi
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Yukiko Fube
- Department of Rehabilitation, Kitakyushu Central Hospital, Japan
| | - Yohei Aritake
- Department of Rehabilitation, Kitakyushu Central Hospital, Japan
| | | | - Kayo Izumitani
- Department of Pharmacy, Kitakyushu Central Hospital, Japan
| | - Mayumi Suzuki
- Department of Clinical Laboratory, Kitakyushu Central Hospital, Japan
| | - Masami Omori
- Department of Rehabilitation, Tobata Kyoritsu Hospital, Japan
| | - Tatsuji Kato
- Department of Respiratory Medicine, Tobata Kyoritsu Hospital, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
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Takazono T, Ngwe Tun MM, Funakoshi S, Morimoto S, Ota K, Torigoe K, Abe S, Muta K, Ito Y, Ashizawa N, Kitamura M, Takeda K, Iwanaga N, Ide S, Tashiro M, Hosogaya N, Nishino T, Yanagihara K, Izumikawa K, Morita K, Mukae H. Long-Term Neutralizing Antibody Titers After BNT162b2 Vaccination in Hemodialysis Patients. Kidney Int Rep 2023; 8:1883-1886. [PMID: 37705908 PMCID: PMC10496013 DOI: 10.1016/j.ekir.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 06/02/2023] [Accepted: 06/12/2023] [Indexed: 09/15/2023] Open
Affiliation(s)
- Takahiro Takazono
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Mya Myat Ngwe Tun
- Department of Virology, Institute of Tropical Medicine and Leading Program, Nagasaki University, Nagasaki, Japan
- Department of Tropical Viral Vaccine Development, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- DEJIMA Infectious Disease Research Alliance, Nagasaki University, Nagasaki, Japan
| | | | - Shimpei Morimoto
- Innovation Platform and Office for Precision Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Kenji Ota
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Kenta Torigoe
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shinichi Abe
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kumiko Muta
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yuya Ito
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Nobuyuki Ashizawa
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Mineaki Kitamura
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuaki Takeda
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Naoki Iwanaga
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Shotaro Ide
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Masato Tashiro
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naoki Hosogaya
- Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Tomoya Nishino
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Koichi Izumikawa
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kouichi Morita
- Department of Virology, Institute of Tropical Medicine and Leading Program, Nagasaki University, Nagasaki, Japan
- DEJIMA Infectious Disease Research Alliance, Nagasaki University, Nagasaki, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
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Tanaka T, Tashiro M, Ota K, Fujita A, Sawai T, Kadota J, Fukuda Y, Sumiyoshi M, Ide S, Tachikawa N, Fujii H, Hibino M, Shiomi H, Izumida M, Matsui K, Yamauchi M, Takahashi K, Yamanashi H, Sugimoto T, Akabame S, Umeda M, Shimizu M, Hosogaya N, Kosai K, Takeda K, Iwanaga N, Ashizawa N, Hirayama T, Takazono T, Yamamoto K, Imamura Y, Miyazaki T, Kobayashi Y, Ariyoshi K, Mukae H, Yanagihara K, Kita K, Izumikawa K. Safety and efficacy of 5-aminolevulinic acid phosphate/iron in mild-to-moderate coronavirus disease 2019: A randomized exploratory phase II trial. Medicine (Baltimore) 2023; 102:e34858. [PMID: 37653769 PMCID: PMC10470697 DOI: 10.1097/md.0000000000034858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/09/2023] [Accepted: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND 5-aminolevulinic acid (5-ALA), a natural amino acid that is marketed alongside sodium ferrous citrate (SFC) as a functional food, blocks severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) proliferation in vitro and exerts anti-inflammatory effects. In this phase II open-label, prospective, parallel-group, randomized trial, we aimed to evaluate the safety and efficacy of 5-ALA in patients with mild-to-moderate coronavirus disease 2019. METHODS This trial was conducted in patients receiving 5-ALA/SFC (250/145 mg) orally thrice daily for 7 days, followed by 5-ALA/SFC (150/87 mg) orally thrice daily for 7 days. The primary endpoints were changes in SARS-CoV-2 viral load, clinical symptom scores, and 5-ALA/SFC safety (adverse events [AE] and changes in laboratory values and vital signs). RESULTS A total of 50 patients were enrolled from 8 institutions in Japan. The change in SARS-CoV-2 viral load from baseline was not significantly different between the 5-ALA/SFC (n = 24) and control (n = 26) groups. The duration to improvement was shorter in the 5-ALA/SFC group than in the control group, although the difference was not significant. The 5-ALA/SFC group exhibited faster improvement rates in "taste abnormality," "cough," "lethargy," and "no appetite" than the control group. Eight AEs were observed in the 5-ALA/SFC group, with 22.7% of patients experiencing gastrointestinal symptoms (decreased appetite, constipation, and vomiting). AEs occurred with 750/435 mg/day in 25.0% of patients in the first phase and with 450/261 mg/day of 5-ALA/SFC in 6.3% of patients in the second phase. CONCLUSION 5-ALA/SFC improved some symptoms but did not influence the SARS-CoV-2 viral load or clinical symptom scores over 14 days. The safety of 5-ALA/SFC in this study was acceptable. Further evaluation using a larger sample size or modified method is warranted.
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Affiliation(s)
- Takeshi Tanaka
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Masato Tashiro
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki-shi, Nagasaki, Japan
| | - Kenji Ota
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Ayumi Fujita
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Toyomitsu Sawai
- Department of Respiratory Medicine, Nagasaki Harbor Medical Center, Nagasaki-shi, Nagasaki, Japan
| | - Junichi Kadota
- Department of Respiratory Medicine, Nagasaki Harbor Medical Center, Nagasaki-shi, Nagasaki, Japan
| | - Yuichi Fukuda
- Department of Respiratory Medicine, Sasebo City General Hospital, Sasebo-shi, Nagasaki, Japan
| | - Makoto Sumiyoshi
- Department of Respiratory Medicine, Isahaya General Hospital, Japan Community Health Care Organization, Isahaya-shi, Nagasaki, Japan
| | - Shotaro Ide
- Department of Respiratory Medicine, Isahaya General Hospital, Japan Community Health Care Organization, Isahaya-shi, Nagasaki, Japan
| | - Natsuo Tachikawa
- Department of Infectious Diseases, Yokohama Municipal Citizen’s Hospital, Yokohama-shi, Kanagawa, Japan
| | - Hiroshi Fujii
- Department of Respiratory Medicine, Kobe City Medical Center West Hospital, Kobe-shi, Hyogo, Japan
| | - Makoto Hibino
- Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, Fujisawa-shi, Kanagawa, Japan
| | - Hisanori Shiomi
- Department of Surgery, Nagahama Red Cross Hospital, Nagahama-shi, Shiga, Japan
| | - Mai Izumida
- Department of Infectious Diseases, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Kohsuke Matsui
- Department of Infectious Diseases, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Momoko Yamauchi
- Department of Infectious Diseases, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Kensuke Takahashi
- Department of Infectious Diseases, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Hirotomo Yamanashi
- Department of Infectious Diseases, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
- Department of General Medicine, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Takashi Sugimoto
- Department of Infectious Diseases, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Shogo Akabame
- Department of General Medicine, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Masataka Umeda
- Department of General Medicine, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Masumi Shimizu
- Department of Infectious Diseases, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Naoki Hosogaya
- Clinical Research Center, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Kosuke Kosai
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Kazuaki Takeda
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Naoki Iwanaga
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Nobuyuki Ashizawa
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Tatsuro Hirayama
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Takahiro Takazono
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki-shi, Nagasaki, Japan
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Kazuko Yamamoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Yoshifumi Imamura
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Taiga Miyazaki
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Yusuke Kobayashi
- Clinical Development Department, Neopharma Japan Co. Ltd., Chiyoda-ku, Tokyo, Japan
| | - Koya Ariyoshi
- Department of Infectious Diseases, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki-shi, Nagasaki, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Kiyoshi Kita
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki-shi, Nagasaki, Japan
- Department of Host-Defense Biochemistry, Institute of Tropical Medicine Nagasaki University, Nagasaki-shi, Nagasaki, Japan
| | - Koichi Izumikawa
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki-shi, Nagasaki, Japan
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Sakamoto N, Okuno D, Tokito T, Yura H, Kido T, Ishimoto H, Tanaka Y, Mukae H. HSP47: A Therapeutic Target in Pulmonary Fibrosis. Biomedicines 2023; 11:2387. [PMID: 37760828 PMCID: PMC10525413 DOI: 10.3390/biomedicines11092387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/19/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease characterized by a progressive decline in lung function and poor prognosis. The deposition of the extracellular matrix (ECM) by myofibroblasts contributes to the stiffening of lung tissue and impaired oxygen exchange in IPF. Type I collagen is the major ECM component and predominant collagen protein deposited in chronic fibrosis, suggesting that type I collagen could be a target of drugs for fibrosis treatment. Heat shock protein 47 (HSP47), encoded by the serpin peptidase inhibitor clade H, member 1 gene, is a stress-inducible collagen-binding protein. It is an endoplasmic reticulum-resident molecular chaperone essential for the correct folding of procollagen. HSP47 expression is increased in cellular and animal models of pulmonary fibrosis and correlates with pathological manifestations in human interstitial lung diseases. Various factors affect HSP47 expression directly or indirectly in pulmonary fibrosis models. Overall, understanding the relationship between HSP47 expression and pulmonary fibrosis may contribute to the development of novel therapeutic strategies.
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Affiliation(s)
- Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Daisuke Okuno
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Takatomo Tokito
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Hirokazu Yura
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Takashi Kido
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Hiroshi Ishimoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Yoshimasa Tanaka
- Center for Medical Innovation, Nagasaki University, Nagasaki 852-8588, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
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45
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Ogata R, Kido T, Takeda K, Nemoto K, Heima R, Takao M, Miyashita R, Ozasa M, Tokito T, Okuno D, Ito Y, Yura H, Koga T, Hashimoto K, Takemoto S, Takazono T, Ishimoto H, Sakamoto N, Fukuda K, Sasaki Y, Obase Y, Ishimatsu Y, Yatera K, Izumikawa K, Mukae H. Disseminated Mycobacterium genavense Infection Mimicking Sarcoidosis: A Case Report and Review of Literature on Japanese Patients. Microorganisms 2023; 11:2145. [PMID: 37763989 PMCID: PMC10535052 DOI: 10.3390/microorganisms11092145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/19/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
Sarcoidosis is a systemic inflammatory disease characterized by noncaseating epithelioid cell granulomas. However, certain infections can exhibit similar histological findings. We present a case of a 69-year-old man who was initially diagnosed with sarcoidosis and later was confirmed, through 16S rRNA sequencing, to have disseminated Mycobacterium genavense infection. Acid-fast bacteria were detected in the bone marrow biopsy using Ziehl-Neelsen staining, but routine clinical tests did not provide a definitive diagnosis. The patient tested negative for HIV, anti-interferon-gamma antibodies, and genetic immunodeficiency disorders. He was treated with multiple drugs, including aminoglycosides and macrolides, but showed no improvement in fever and pancytopenia. However, these clinical signs responded favorably to steroid therapy. We reviewed 17 Japanese cases of M. genavense infection. All cases were in males; 7/17 (41%) were HIV-negative; and 12/17 (71%) had a decreased CD4 count. Genetic analysis confirmed M. genavense isolation, and macrolides were used universally. Mycobacterium genavense infection is challenging to identify and mimics other systemic inflammatory diseases such as sarcoidosis. There are no standard treatment protocols. Our case report and Japanese case review contribute to understanding this rare disease.
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Affiliation(s)
- Ryo Ogata
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan; (R.O.); (K.T.); (R.M.); (M.O.); (T.T.); (D.O.); (Y.I.); (H.Y.); (S.T.); (T.T.); (H.I.); (N.S.); (Y.O.); (H.M.)
| | - Takashi Kido
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan; (R.O.); (K.T.); (R.M.); (M.O.); (T.T.); (D.O.); (Y.I.); (H.Y.); (S.T.); (T.T.); (H.I.); (N.S.); (Y.O.); (H.M.)
| | - Kazuaki Takeda
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan; (R.O.); (K.T.); (R.M.); (M.O.); (T.T.); (D.O.); (Y.I.); (H.Y.); (S.T.); (T.T.); (H.I.); (N.S.); (Y.O.); (H.M.)
| | - Kazuki Nemoto
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyusyu 807-8556, Japan; (K.N.); (K.Y.)
| | - Riko Heima
- Clinical Genomics Center, Nagasaki University Hospital, Nagasaki 852-8501, Japan; (R.H.); (M.T.)
| | - Mami Takao
- Clinical Genomics Center, Nagasaki University Hospital, Nagasaki 852-8501, Japan; (R.H.); (M.T.)
| | - Ritsuko Miyashita
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan; (R.O.); (K.T.); (R.M.); (M.O.); (T.T.); (D.O.); (Y.I.); (H.Y.); (S.T.); (T.T.); (H.I.); (N.S.); (Y.O.); (H.M.)
| | - Mutsumi Ozasa
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan; (R.O.); (K.T.); (R.M.); (M.O.); (T.T.); (D.O.); (Y.I.); (H.Y.); (S.T.); (T.T.); (H.I.); (N.S.); (Y.O.); (H.M.)
| | - Takatomo Tokito
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan; (R.O.); (K.T.); (R.M.); (M.O.); (T.T.); (D.O.); (Y.I.); (H.Y.); (S.T.); (T.T.); (H.I.); (N.S.); (Y.O.); (H.M.)
| | - Daisuke Okuno
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan; (R.O.); (K.T.); (R.M.); (M.O.); (T.T.); (D.O.); (Y.I.); (H.Y.); (S.T.); (T.T.); (H.I.); (N.S.); (Y.O.); (H.M.)
| | - Yuya Ito
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan; (R.O.); (K.T.); (R.M.); (M.O.); (T.T.); (D.O.); (Y.I.); (H.Y.); (S.T.); (T.T.); (H.I.); (N.S.); (Y.O.); (H.M.)
| | - Hirokazu Yura
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan; (R.O.); (K.T.); (R.M.); (M.O.); (T.T.); (D.O.); (Y.I.); (H.Y.); (S.T.); (T.T.); (H.I.); (N.S.); (Y.O.); (H.M.)
| | - Tomohiro Koga
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan;
| | - Kunio Hashimoto
- Department of Pediatrics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan;
| | - Shinnosuke Takemoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan; (R.O.); (K.T.); (R.M.); (M.O.); (T.T.); (D.O.); (Y.I.); (H.Y.); (S.T.); (T.T.); (H.I.); (N.S.); (Y.O.); (H.M.)
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan; (R.O.); (K.T.); (R.M.); (M.O.); (T.T.); (D.O.); (Y.I.); (H.Y.); (S.T.); (T.T.); (H.I.); (N.S.); (Y.O.); (H.M.)
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan;
| | - Hiroshi Ishimoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan; (R.O.); (K.T.); (R.M.); (M.O.); (T.T.); (D.O.); (Y.I.); (H.Y.); (S.T.); (T.T.); (H.I.); (N.S.); (Y.O.); (H.M.)
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan; (R.O.); (K.T.); (R.M.); (M.O.); (T.T.); (D.O.); (Y.I.); (H.Y.); (S.T.); (T.T.); (H.I.); (N.S.); (Y.O.); (H.M.)
| | - Kazumasa Fukuda
- Department of Microbiology, University of Occupational and Environmental Health, Japan, Kitakyusyu 807-8556, Japan;
| | - Yuka Sasaki
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo 204-8585, Japan;
| | - Yasushi Obase
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan; (R.O.); (K.T.); (R.M.); (M.O.); (T.T.); (D.O.); (Y.I.); (H.Y.); (S.T.); (T.T.); (H.I.); (N.S.); (Y.O.); (H.M.)
| | - Yuji Ishimatsu
- Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8520, Japan;
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyusyu 807-8556, Japan; (K.N.); (K.Y.)
| | - Koichi Izumikawa
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan;
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan; (R.O.); (K.T.); (R.M.); (M.O.); (T.T.); (D.O.); (Y.I.); (H.Y.); (S.T.); (T.T.); (H.I.); (N.S.); (Y.O.); (H.M.)
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Ito G, Takazono T, Hosogaya N, Iwanaga N, Miyazawa S, Fujita S, Watanabe H, Mukae H. Impact of meteorological and demographic factors on the influenza epidemic in Japan: a large observational database study. Sci Rep 2023; 13:13000. [PMID: 37563139 PMCID: PMC10415347 DOI: 10.1038/s41598-023-39617-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/27/2023] [Indexed: 08/12/2023] Open
Abstract
Factors affecting the start date of the influenza epidemic season and total number of infected persons per 1,000,000 population in 47 prefectures of Japan were evaluated. This retrospective observational study (September 2014-August 2019; N = 472,740-883,804) evaluated data from a Japanese health insurance claims database. Single and multiple regression analyses evaluated the time to start of the epidemic or total infected persons per 1,000,000 population with time to absolute humidity (AH) or number of days with AH (≤ 5.5, ≤ 6.0, ≤ 6.5, and ≤ 7.0), total visitors (first epidemic month or per day), and total population. For the 2014/15, 2015/16, and 2016/17 seasons, a weak-to-moderate positive correlation (R2: 0.042-0.417) was observed between time to start of the epidemic and time to first day with AH below the cutoff values. Except in the 2016/17 season (R2: 0.089), a moderate correlation was reported between time to start of the epidemic and the total population (R2: 0.212-0.401). For all seasons, multiple regression analysis showed negative R2 for time to start of the epidemic and total visitors and population density (positive for time to AH ≤ 7.0). The earlier the climate becomes suitable for virus transmission and the higher the human mobility (more visitors and higher population density), the earlier the epidemic season tends to begin.
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Affiliation(s)
- Genta Ito
- Data Science Department, Shionogi & Co., Ltd, Osaka, Japan
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.
| | - Naoki Hosogaya
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Naoki Iwanaga
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Shogo Miyazawa
- Data Science Department, Shionogi & Co., Ltd, Osaka, Japan
| | - Satoki Fujita
- Data Science Department, Shionogi & Co., Ltd, Osaka, Japan
| | | | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
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Ishimoto H, Sakamoto N, Kido T, Ozasa M, Tsutsui S, Mori M, Setoguchi D, Takemoto S, Obase Y, Ishimatsu Y, Tomonaga C, Matsumoto K, Morisaki S, Miura K, Mukae H. Drug-induced interstitial lung disease caused by olaparib: three case reports and review of the Japanese Adverse Drug Event Report database and literature. BMC Pulm Med 2023; 23:289. [PMID: 37553592 PMCID: PMC10408235 DOI: 10.1186/s12890-023-02569-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 07/17/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Olaparib, a poly (ADP-ribose) polymerase (PARP) inhibitor, has demonstrated effectiveness in treating ovarian, breast, and other cancers, particularly those with specific molecular subtypes including, but not limited to, BRCA1/2 mutations. Consequently, its utilization is expected to increase in the future. For this reason, it is important to acknowledge the potential for adverse events associated with olaparib, including the relatively rare but significant risk of drug-induced interstitial lung disease (DIILD). Since DIILD can lead to fatal outcomes, its early detection is crucial. The dissemination of knowledge regarding DIILD can be facilitated through case reports; however, specific reports of DIILD caused by olaparib have only been published in Japanese. To the best of our knowledge, this is the first report in English of our experience with three cases of DIILD caused by olaparib. CASE PRESENTATION Cases 1, 2, and 3 involved Japanese women with ovarian cancer who had been receiving olaparib at a dose of 600 mg/day. Case 1, a 72-year-old woman who had been on olaparib for 4 months, and case 2, a 51-year-old woman who had been on olaparib for 8 months, reported fever and general malaise. Chest computed tomography (CT) revealed pale ground glass opacity (GGO) similar to hypersensitivity pneumonitis. The severity grade was 2 in both cases. Case 3, a 78-year-old woman who had been on olaparib for 3 weeks, presented with cough and reported dyspnea on exertion. Chest CT revealed non-specific interstitial pneumonia and organizing pneumonia-like shadows. The severity grade was 4. Olaparib was discontinued in all cases. Case 1 received 0.6 mg/kg of prednisolone due to mild hypoxia, while prednisolone was not administered in case 2 due to the absence of hypoxia. Case 3 received steroid pulse therapy due to severe hypoxia. Olaparib administration was not resumed in any patient. CONCLUSION DIILD caused by olaparib in Japan, including the present three cases, commonly presents with GGO, similar to hypersensitivity pneumonitis on chest CT. The prognosis for the majority of patients is favorable; however, there have been instances of severe cases. Early recognition of drug-induced lung injury and further accumulation of cases is important.
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Affiliation(s)
- Hiroshi Ishimoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
| | - Takashi Kido
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Mutsumi Ozasa
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Shin Tsutsui
- Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Mayako Mori
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Daichi Setoguchi
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Shinnosuke Takemoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Yasushi Obase
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Yuji Ishimatsu
- Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8520, Japan
| | - Chiharu Tomonaga
- Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Kanako Matsumoto
- Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Sachiko Morisaki
- Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Kiyonori Miura
- Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
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Hosogaya N, Takazono T, Kurazono K, Hiroi S, Iwasaki K, Takeshima T, Ha C, Mukae H. Estimation of Intangible Costs for Factors Associated with Oral Antiviral Drugs for COVID-19 Treatment: A Conjoint Analysis in Japan. Adv Ther 2023; 40:3525-3542. [PMID: 37303032 PMCID: PMC10258079 DOI: 10.1007/s12325-023-02564-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/18/2023] [Indexed: 06/13/2023]
Abstract
INTRODUCTION During the recent coronavirus disease 2019 (COVID-19) pandemic, preferences for factors associated with vaccines have been evaluated. Three oral antiviral drugs have been approved in Japan for patients with mild-to-moderate I COVID-19 symptoms. Although preferences for the drugs may also depend on various factors, these have not been fully evaluated. METHODS A conjoint analysis was performed based on an online survey in August 2022 to estimate the intangible costs of factors associated with oral antiviral drugs for COVID-19. Respondents were individuals aged 20-69 across Japan. The attributes included the company (Japanese/foreign) that developed the drug, formulation and size of the drug, frequency of administration per day, number of tablets/capsules per dose, number of days until no longer infectious to others, and out-of-pocket expenses. A logistic regression model was applied to estimate the utility of each level for each attribute. The intangible costs were calculated by comparing the utility to the out-of-pocket attribute. RESULTS Responses were collected from 11,303 participants. The difference between levels was the largest for companies that developed a drug; the intangible costs were JPY 5390 higher for the foreign company than for the Japanese company. The next largest difference was in the number of days until one is no longer infectious. For the same formulation, the intangible cost was lower for small sizes than large sizes. For similar-sized tablets and capsules, the intangible cost was lower for tablets than capsules. These tendencies were similar regardless of COVID-19 infection history and the presence of risk factors for severe COVID-19 in the respondents. CONCLUSION Intangible costs for factors associated with oral antiviral drugs among the Japanese population were estimated. The results may change as the number of people with a history of COVID-19 infection increases and significant progress is made regarding treatments.
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Affiliation(s)
- Naoki Hosogaya
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
- Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
| | | | - Shinzo Hiroi
- Medical Affairs, Shionogi & Co., Ltd, Osaka, Japan
| | | | | | | | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Koga S, Takazono T, Kido T, Muramatsu K, Tokutsu K, Tokito T, Okuno D, Ito Y, Yura H, Takeda K, Iwanaga N, Ishimoto H, Sakamoto N, Yatera K, Izumikawa K, Yanagihara K, Fujino Y, Fushimi K, Matsuda S, Mukae H. Evaluation of the Effectiveness and Use of Anti-Methicillin-Resistant Staphylococcus aureus Agents for Aspiration Pneumonia in Older Patients Using a Nationwide Japanese Administrative Database. Microorganisms 2023; 11:1905. [PMID: 37630465 PMCID: PMC10456764 DOI: 10.3390/microorganisms11081905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023] Open
Abstract
Studies indicated potential harm from empirical broad-spectrum therapy. A recent study of hospitalizations for community-acquired pneumonia suggested that empirical anti-methicillin-resistant Staphylococcus aureus (MRSA) therapy was associated with an increased risk of death and other complications. However, limited evidence supports empirical anti-MRSA therapy for older patients with aspiration pneumonia. In a nationwide Japanese database, patients aged ≥65 years on admission with aspiration pneumonia were analyzed. Patients were divided based on presence of respiratory failure and further sub-categorized based on their condition within 3 days of hospital admission, either receiving a combination of anti-MRSA agents and other antibiotics, or not using MRSA agents. An inverse probability weighting method with estimated propensity scores was used. Out of 81,306 eligible patients, 55,098 had respiratory failure, and 26,208 did not. In the group with and without respiratory failure, 0.93% and 0.42% of the patients, respectively, received anti-MRSA agents. In patients with respiratory failure, in-hospital mortality (31.38% vs. 19.03%, p < 0.001), 30-day mortality, and 90-day mortality were significantly higher, and oxygen administration length was significantly longer in the anti-MRSA agent combination group. Anti-MRSA agent combination use did not improve the outcomes in older patients with aspiration pneumonia and respiratory failure, and should be carefully and comprehensively considered.
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Affiliation(s)
- Satoru Koga
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan
| | - Takashi Kido
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Keiji Muramatsu
- Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Japan, Kitakyusyu 807-8555, Japan
| | - Kei Tokutsu
- Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Japan, Kitakyusyu 807-8555, Japan
| | - Takatomo Tokito
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Daisuke Okuno
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Yuya Ito
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Hirokazu Yura
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Kazuaki Takeda
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Naoki Iwanaga
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Hiroshi Ishimoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyusyu 807-8555, Japan
| | - Koichi Izumikawa
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Science, University of Occupational and Environmental Health, Japan, Kitakyusyu 807-8555, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Shinya Matsuda
- Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Japan, Kitakyusyu 807-8555, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
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50
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Murata M, Kosai K, Akamatsu N, Matsuyama Y, Oda M, Wakamatsu A, Izumikawa K, Mukae H, Yanagihara K. Diagnostic Performance of BD Phoenix CPO Detect Panels for Detection and Classification of Carbapenemase-Producing Gram-Negative Bacteria. Microbiol Spectr 2023; 11:e0089723. [PMID: 37162344 PMCID: PMC10269800 DOI: 10.1128/spectrum.00897-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/11/2023] [Indexed: 05/11/2023] Open
Abstract
BD Phoenix CPO Detect panels can identify and classify carbapenemase-producing organisms (CPOs) simultaneously with antimicrobial susceptibility testing (AST) for Gram-negative bacteria. Detection and classification of carbapenemase producers were performed using the BD Phoenix CPO Detect panels NMIC/ID-441 for Enterobacterales, NMIC/ID-442 for nonfermenting bacteria, and NMIC-440 for both. The results were compared with those obtained using comparator methods. A total of 133 strains (32 Klebsiella pneumoniae, 37 Enterobacter cloacae complex, 33 Pseudomonas aeruginosa, and 31 Acinetobacter baumannii complex strains), including 60 carbapenemase producers (54 imipenemases [IMPs] and 6 OXA type), were analyzed. Using panels NMIC-440 and NMIC/ID-441 or NMIC/ID-442, all 54 IMP producers were accurately identified as CPOs (positive percent agreement [PPA], 100.0%; 54/54). Among the 54 IMP producers identified as CPOs using panels NMIC-440 and NMIC/ID-441, 12 and 14 Enterobacterales were not resistant to carbapenem, respectively. Among all 54 IMP producers, 48 (88.9%; 48/54) were correctly classified as Ambler class B using panel NMIC-440. Using panels NMIC-440 and NMIC/ID-442, all four OXA-23-like carbapenemase-producing A. baumannii complex strains (100.0%, 4/4) were correctly identified as CPOs, and three (75.0%, 3/4) were precisely classified as class D using panel NMIC-440. Both carbapenemase producers harboring the blaISAba1-OXA-51-like gene were incorrectly identified as non-CPOs using panels NMIC-440 and NMIC/ID-442. For detecting carbapenemase producers, the overall PPA and negative percent agreement (NPA) between panel NMIC-440 and the comparator methods were 96.7% (58/60) and 71.2% (52/73), respectively, and the PPA and NPA between panels NMIC/ID-441 or NMIC/ID-442 and the comparator methods were 96.7% (58/60) and 74.0% (54/73), respectively. BD Phoenix CPO Detect panels can successfully screen carbapenemase producers, particularly IMP producers, regardless of the presence of carbapenem resistance and can be beneficial in routine AST workflows. IMPORTANCE Simple and efficient screening methods of detecting carbapenemase producers are required. BD Phoenix CPO Detect panels effectively screened carbapenemase producers, particularly IMP producers, with a high overall PPA. As the panels enable automatic screening for carbapenemase producers simultaneously with AST, the workflow from AST to confirmatory testing for carbapenemase production can be shortened. In addition, because carbapenem resistance varies among carbapenemase producers, the BD Phoenix CPO Detect panels, which can screen carbapenemase producers regardless of carbapenem susceptibility, can contribute to the accurate detection of carbapenemase producers. Our results report that these panels can help streamline the AST workflow before confirmatory testing for carbapenemase production in routine microbiological tests.
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Affiliation(s)
- Mika Murata
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Kosuke Kosai
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Norihiko Akamatsu
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | | | - Mitsuharu Oda
- Nippon Becton, Dickinson Company, Ltd., Minato, Tokyo, Japan
| | | | - Koichi Izumikawa
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
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